creative writing as a therapy

Writing Therapy: How to Write and Journal Therapeutically

Writing Therapy: Using A Pen and Paper to Enhance Personal Growth

Of course, the answer to that question will be “yes” for everyone!

We all fall on hard times, and we all struggle to get back to our equilibrium.

For some, getting back to equilibrium can involve seeing a therapist. For others, it could be starting a new job or moving to a new place. For some of the more literary-minded or creative folks, getting better can begin with art.

There are many ways to incorporate art into spiritual healing and emotional growth, including drawing, painting, listening to music, or dancing. These methods can be great for artistic people, but there are also creative and expressive ways to dig yourself out of a rut that don’t require any special artistic talents.

One such method is writing therapy. You don’t need to be a prolific writer, or even a writer at all, to benefit from writing therapy. All you need is a piece of paper, a pen, and the motivation to write.

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This Article Contains:

What Is Writing Therapy?

Benefits of Writing Therapy

How to: journaling for therapy, writing ideas & journal prompts, exercises and ideas to help you get started, a take-home message, what is writing therapy.

Writing therapy, also known as journal therapy, is exactly what it sounds like: writing (often in a journal) for therapeutic benefits.

Writing therapy is a low-cost, easily accessible, and versatile form of therapy . It can be done individually, with just a person and a pen, or guided by a mental health professional. It can also be practiced in a group, with group discussions focusing on writing. It can even be added as a supplement to another form of therapy.

Whatever the format, writing therapy can help the individual propel their personal growth , practice creative expression, and feel a sense of empowerment and control over their life (Adams, n.d.).

It’s easy to see the potential of therapeutic writing. After all, poets and storytellers throughout the ages have captured and described the cathartic experience of putting pen to paper. Great literature from such poets and storytellers makes it tempting to believe that powerful healing and personal growth are but a few moments of scribbling away.

However, while writing therapy seems as simple as writing in a journal , there’s a little more to it.

Writing therapy differs from simply keeping a journal or diary in three major ways (Farooqui, 2016):

Writing in a diary or journal is usually free-form, where the writer jots down whatever pops into their head. Therapeutic writing is typically more directed and often based on specific prompts or exercises guided by a professional.
Writing in a diary or journal may focus on recording events as they occur, while writing therapy is often focused on more meta-analytical processes: thinking about, interacting with, and analyzing the events, thoughts, and feelings that the writer writes down.
Keeping a diary or journal is an inherently personal and individual experience, while journal therapy is generally led by a licensed mental health professional.

While the process of writing therapy differs from simple journaling in these three main ways, there is also another big difference between the two practices in terms of outcomes.

man writing - what is writing therapy journal therapy

These are certainly not trivial benefits, but the potential benefits of writing therapy reach further and deeper than simply writing in a diary.

For individuals who have experienced a traumatic or extremely stressful event, expressive writing guided purposefully toward specific topics can have a significant healing effect. In fact, participants in a study who wrote about their most traumatic experiences for 15 minutes, four days in a row, experienced better health outcomes up to four months than those who were instructed to write about neutral topics (Baikie & Wilhelm, 2005).

Another study tested the same writing exercise on over 100 asthma and rheumatoid arthritis patients, with similar results. The participants who wrote about the most stressful event of their lives experienced better health evaluations related to their illness than the control group, who wrote about emotionally neutral topics (Smyth et al., 1999).

Expressive writing may even improve immune system functioning, although the writing practice may need to be sustained for the health benefits to continue (Murray, 2002).

In addition to these more concrete benefits, regular therapeutic writing can help the writer find meaning in their experiences, view things from a new perspective, and see the silver linings in their most stressful or negative experiences (Murray, 2002). It can also lead to important insights about yourself and your environment that may be difficult to determine without focused writing (Tartakovsky, 2015).

Overall, writing therapy has proven effective for different conditions and mental illnesses, including (Farooqui, 2016):

Post-traumatic stress
Obsessive-compulsive disorder
Grief and loss
Chronic illness issues
Substance abuse
Eating disorders
Interpersonal relationship issues
Communication skill issues
Low self-esteem

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There are many ways to begin writing for therapeutic purposes.

If you are working with a mental health professional, they may provide you with directions to begin journaling for therapy.

While true writing therapy would be conducted with the help of a licensed mental health professional, you may be interested in trying the practice on your own to explore some of the potential benefits to your wellbeing. If so, here there are some good tips to get you started.

First, think about how to set yourself up for success:

Use whichever format works best for you, whether it’s a classic journal, a cheap notebook, an online journaling program, or a blog.
If it makes you more interested in writing, decorate or personalize your journal/notebook/blog.
Set a goal to write for a certain amount of time each day.
Decide ahead of time when and/or where you will write each day.
Consider what makes you want to write in the first place. This could be your first entry in your journal.

Next, follow the five steps to WRITE (Adams, n.d.):

W – What do you want to write about? Name it.
R – Review or reflect on your topic. Close your eyes, take deep breaths, and focus.
I – Investigate your thoughts and feelings. Just start writing and keep writing.
T – Time yourself. Write for five to 15 minutes straight.
E – Exit “smart” by re-reading what you’ve written and reflecting on it with one or two sentences

Finally, keep the following in mind while you are journaling (Howes, 2011):

It’s okay to write only a few words, and it’s okay to write several pages. Write at your own pace.
Don’t worry about what to write about. Just focus on taking the time to write and giving it your full attention.
Don’t worry about how well you write. The important thing is to write down what makes sense and comes naturally to you.
Remember that no-one else needs to read what you’ve written. This will help you write authentically and avoid “putting on a show.”

It might be difficult to get started, but the first step is always the hardest! Once you’ve started journaling, try one of the following ideas or prompts to keep yourself engaged.

Journaling with Photographs writing therapy

Here are five writing exercises designed for dealing with pain (Abundance No Limits, n.d.):

Write a letter to yourself
Write letters to others
Write a poem
Free write (just write everything and anything that comes to mind)
Mind map (draw mind maps with your main problem in the middle and branches representing different aspects of your problem)

If those ideas don’t get your juices flowing, try these prompts (Farooqui, 2016):

Journal with photographs – Choose a personal photo and use your journal to answer questions like “What do you feel when you look at these photos?” and “What do you want to say to the people, places, or things in these photos?”
Timed journal entries – Decide on a topic and set a timer for 10 or 15 minutes to write continuously.
Sentence stems – These prompts are the beginnings of sentences that encourage meaningful writing, such as “The thing I am most worried about is…” “I have trouble sleeping when…” and “My happiest memory is…”
List of 100 – These ideas encourage the writer to create lists of 100 based on prompts like “100 things that make me sad” “100 reasons to wake up in the morning,” and “100 things I love.”

Tartakovsky (2014) provides a handy list of 30 prompts, including:

My favorite way to spend the day is…
If I could talk to my teenage self, the one thing I would say is…
Make a list of 30 things that make you smile.
The words I’d like to live by are…
I really wish others knew this about me…
What always brings tears to your eyes?
Using 10 words, describe yourself.
Write a list of questions to which you urgently need answers.

If you’re still on the lookout for more prompts, try the lists outlined here .

6 Ways to process your feelings in writing – Therapy in a Nutshell

As great as the benefits of therapeutic journaling sound, it can be difficult to get started. After all, it can be a challenge to start even the most basic of good habits!

If you’re wondering how to begin, read on for some tips and exercises to help you start your regular writing habit (Hills, n.d.).

Start writing about where you are in your life at this moment.
For five to 10 minutes just start writing in a “stream of consciousness.”
Start a dialogue with your inner child by writing in your nondominant hand.
Cultivate an attitude of gratitude by maintaining a daily list of things you appreciate, including uplifting quotes .
Start a journal of self-portraits.
Keep a nature diary to connect with the natural world.
Maintain a log of successes.
Keep a log or playlist of your favorite songs.
If there’s something you are struggling with or an event that’s disturbing you, write about it in the third person.

If you’re still having a tough time getting started, consider trying a “mind dump.” This is a quick exercise that can help you get a jump start on therapeutic writing.

Researcher and writer Gillie Bolton suggests simply writing for six minutes (Pollard, 2002). Don’t pay attention to grammar, spelling, style, syntax, or fixing typos – just write. Once you have “dumped,” you can focus on a theme. The theme should be something concrete, like something from your childhood with personal value.

This exercise can help you ensure that your therapeutic journal entries go deeper than superficial diary or journal entries.

More prompts, exercises, and ideas to help you get started can be found by following this link .

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In this piece, we went over what writing therapy is, how to do it, and how it can benefit you and/or your clients. I hope you learned something new from this piece, and I hope you will keep writing therapy in mind as a potential exercise.

Have you ever tried writing therapy? Would you try writing therapy? How do you think it would benefit you? Let us know your thoughts in the comments!

Thanks for reading, and happy writing!

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

Abundance No limits. (n.d.). 5 Writing therapy exercises that can ease your pain . Author. Retrieved from https://www.abundancenolimits.com/writing-therapy-exercises/.
Adams, K. (n.d.). It’s easy to W.R.I.T.E . Center for Journal Therapy . Retrieved from https://journaltherapy.com/journal-cafe-3/journal-course/
Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment 11(5) , 338-346.
Farooqui, A. Z. (2016). Journal therapy . Good Therapy . Retrieved from https://www.goodtherapy.org/learn-about-therapy/types/journal-therapy
Hills, L. (n.d.). 10 journaling tips to help you heal, grow, and thrive . Tiny Buddha . Retrieved from https://tinybuddha.com/blog/10-journaling-tips-to-help-you-heal-grow-and-thrive/
Howes, R. (2011, January 26). Journaling in therapy . Psychology Today. Retrieved from https://www.psychologytoday.com/blog/in-therapy/201101/journaling-in-therapy.
Murray, B. (2002). Writing to heal. Monitor, 33(6), 54. Retrieved from http://www.apa.org/monitor/jun02/writing.aspx
Pollard, J. (2002). As easy as ABC . The Guardian . Retrieved from https://www.theguardian.com/lifeandstyle/2002/jul/28/shopping
Smyth, J. M., Stone, A. A., Hurewitz, A., & Kaell, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. Journal of the American Medical Association 281 , 1304-1309.
Tartakovsky, M. (2014). 30 journaling prompts for self-reflection and self-discovery . Psych Central . Retrieved from https://psychcentral.com/blog/archives/2014/09/27/30-journaling-prompts-for-self-reflection-and-self-discovery/
Tartakovsky, M. (2015). The power of writing: 3 types of therapeutic writing . Psych Central . Retrieved from https://psychcentral.com/blog/archives/2015/01/19/the-power-of-writing-3-types-of-therapeutic-writing/

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What our readers think.

Hello, Such an interesting article, thank you very much. I was wondering if there was a particular strategy in which writing down questions produced answers. I started doing just that: writing down doubts and questions, and I found that answers just came. It was like talking through the issues with someone else. Is there any research on that? Is this a known strategy?

Hi Michael,

That’s amazing that you’re finding answers are ‘arising’ for you in your writing. In meditative and mindfulness practices, this is often referred to as intuition, which points to a form of intelligence that goes beyond rationality and cognition. This is a fairly new area of research, but has been well-recognized by Eastern traditions for centuries. See here for a book chapter review: https://doi.org/10.4337/9780857936370.00029

As you’ve discovered, journaling can be incredibly valuable to put you in touch with this intuitive form of knowing in which solutions just come to you.

This also reminds me of something known as the rubber ducking technique, which programmers use to solve problems and debug code: https://en.wikipedia.org/wiki/Rubber_duck_debugging

Anyway, hope that offers some food for thought!

– Nicole | Community Manager

I have never tried writing therapy, but I intend to. Its so much better than seeing the psychiatrist for my behavior issues, which nobody has even identified yet.

Hi great article, just wondering when it was originally posted as I wish to cite some of the text in my essay Many thanks

Glad you enjoyed the post. It was published on the 26th of October, 2017 🙂

Hope this helps!

Hi Courtney

I know you posted this blog a while ago but I’ve just found it and loved it. It articulated so clearly the benefits of writing therapy. One question – is there any research on whether it’s better to use pen and paper or Ian using a PC/typing just as good. I can write much faster and more fluently when I use a keyboard but wonder whether there is a benefit from the physical act of writing writing with a pen. Thanks.

Great question. The evidence isn’t entirely clear on this, but there’s a little work suggesting that writing by hand forces the mind to slow down and reflect more deeply on what’s being written (see this article ). Further, the process of writing uses parts of the brain involved in emotion, which may make writing by hand more effective for exploring your emotional experiences.

However, when it comes to writing therapy, the factor of personal preference seems critical! The issue of speed can be frustrating if your thoughts tend to come quickly. If you feel writing by hand introduces more frustration than benefits, that may be a sign to keep a digital journal instead.

Hope that helps!

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Writing Can Help Us Heal from Trauma

Deborah Siegel-Acevedo

Three prompts to get started.

Why does a writing intervention work? While it may seem counterintuitive that writing about negative experiences has a positive effect, some have posited that narrating the story of a past negative event or an ongoing anxiety “frees up” cognitive resources. Research suggests that trauma damages brain tissue, but that when people translate their emotional experience into words, they may be changing the way it is organized in the brain. This matters, both personally and professionally. In a moment still permeated with epic stress and loss, we need to call in all possible supports. So, what does this look like in practice, and how can you put this powerful tool into effect? The author offers three practices, with prompts, to get you started.

Even as we inoculate our bodies and seemingly move out of the pandemic, psychologically we are still moving through it. We owe it to ourselves — and our coworkers — to make space for processing this individual and collective trauma. A recent op-ed in the New York Times Sunday Review affirms what I, as a writer and professor of writing, have witnessed repeatedly, up close: expressive writing can heal us.

Deborah Siegel-Acevedo is an author , TEDx speaker, and founder of Bold Voice Collaborative , an organization fostering growth, resilience, and community through storytelling for individuals and organizations. An adjunct faculty member at DePaul University’s College of Communication, her writing has appeared in venues including The Washington Post, The Guardian, and CNN.com.

How to Use Writing Therapy to Release Negative Emotions and Trauma

Whether it’s lyrics or journaling—expression through writing can be cathartic

Ayana is the Associate Editor at Verywell Mind, where she aims to publish mental health content that is both engaging and of high quality.

Yolanda Renteria, LPC, is a licensed therapist, somatic practitioner, national certified counselor, adjunct faculty professor, speaker specializing in the treatment of trauma and intergenerational trauma.

Verywell / Julie Bang

What to Know About Writing Therapy

The Major Benefits of Writing Therapy

How to Get Started With Expressive Writing

Every Friday on The Verywell Mind Podcast , host Minaa B., a licensed social worker, mental health educator, and author of "Owning Our Struggles," interviews experts, wellness advocates, and individuals with lived experiences about community care and its impact on mental health.

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Putting pen to paper feels a bit like an anomaly in a world obsessed with texting, tweeting, and sliding into people’s DMs. But let’s try something different. The next time you’re in your Notes app, give your thumbs a break and grab a pen and piece of paper instead. If you don’t have any paper handy, grab that Starbucks receipt and start writing whatever you were about to type. See how it feels.

It might feel a bit awkward at first, especially if you haven’t had to physically write anything down in a long while. But as you keep writing, you may feel really engaged with the words you’re jotting down. Tapping letters on a screen isn’t the same as drawing out each letter of every word. Writing things down will inherently bond you to the words you write. And because of that, writing becomes quite powerful for the psyche . Aside from being a feel-good activity, writing can also let us process negative emotions and trauma in what turns out to be a pretty soul-cleansing experience.

In fact, singer/songwriter and season three winner of The Voice, Cassadee Pope , seconds this. Pope, who's been in the music industry since she was 11 years old, has been pretty open about her mental health struggles—from bad breakups to the emotional impact of her parent’s divorce. Pope told Minaa B., LMSW , host of The Verywell Mind Podcast, “I needed an outlet with everything that was happening with my family. So that was really what I leaned on most, was songwriting.”

Now, you don’t have to be a gifted songwriter to reap the benefits of writing, but let's talk about why writing can be so good for your mental health.

At a Glance

Writing can be a powerful therapeutic tool. Getting your thoughts down can help you understand them and process them more effectively than keeping them all in your head. People who use writing therapy report better overall mood and fewer depressive symptoms. If you’re struggling with a mental health condition and need to vent your frustrations—consider making a journal your new BFF.

What to Know About Writing Therapy (Write This Down)

Writing therapy (aka emotional disclosure or expressive writing) is pretty much exactly what it sounds like. It involves using writing of any kind, like creative writing, freewriting, and poetry, as a therapeutic tool. Writing therapy can be especially for those who are more withdrawn or have trouble opening up to others.

Writing therapy can be so beneficial to our mental health because it’s basically a form of venting. You know how good it feels to come home after a long day of work and go on and on about how much you dislike that one coworker for a reason you can’t even put your finger on. Or when you spill all of your dating frustrations to your bestie over the phone. It’s a nice release of stress. You can release stress in a similar way when you write, too. Just pretend that piece of paper is your therapist, closest confidante, or even yourself.

No one else has to know whatever you choose to jot down (or rage-write about). Your journal or diary is your personal safe haven, and your innermost thoughts are safe on those pages.

Research shows that writing about painful experiences can even improve your immune system. Getting all of your thoughts out on paper is a big stress reliever. It’s also known that trying to suppress negative emotions can be detrimental to your overall well-being, so verbal release may only help you in the long run. Another advantage of writing therapy is that it gives your emotions and thoughts some structure. For instance, my therapist knows I love writing—especially writing poetry. So, when I was dealing with a particularly traumatic time in my life, she told me that my next few homework assignments would be to write poetry about my feelings. Because poetry is a form of creative writing, I had to really think about the diction and imagery I wanted to convey in the poems.

As a result, I really had to unpack my feelings so that my poem would paint a clear picture of what I was going through. I worked on the poem each night before bed and had it ready for my next weekly session.

The next day, I hopped online to meet with my therapist and tell her I had completed my assignment. In response, she asked me to read it aloud. What?! I quickly grew nervous since I was not expecting that. But, considering she’s never led me astray, I reluctantly recited my poem. It was an emotional experience, and my voice audibly cracked a few times, but it felt really good—euphoric, even. So when Pope says that singing her lyrics is "cathartic," I completely get it. She says her singing can be a bit “disarming” because “ I’m believing every word so intensely, and I feel them so intensely.”

So, not only does writing release some deep-seated feelings, orating them breathes life into them. There’s this particularly beautiful Chinese proverb that says: ‘I hear and I forget, I see and I remember, I write and I understand.’ Once our thoughts are written down, we can see them in front of us, through this practice they become real. Then, we can dig in and unpack what it all means to us.

Other Benefits of Writing Therapy

If you’re still not convinced about the power of writing, here are some other amazing benefits of writing to take note of (pun intended):

Lowered blood pressure
Reduced anxiety and depression symptoms
Improved cognition
Increased antibody production
Better overall mood

Ready to Get Started With Expressive Writing?—Here’s How

The great thing about writing is that it can be about anything you want. There are zero restrictions on what you can say. If you’ve had an upsetting experience or need to release some frustrations about daily stressors, try writing about it.

Pope talks about how she’s been using songwriting to get more authentic about her life as of late. In fact, she was kind enough to dish on the details about a new song of hers that’s set to release soon titled “Three of Us.” In this track, she details what it’s like being the “third wheel” when you’re in a relationship with someone who’s dealing with a substance use disorder : “It's about me, you, and the drugs.” In describing the lyrics, she says, “It's probably the most revealing song I've ever released.”

Now, if you’ve already got an experience you want to write about, feel free to get started when you’re alone and in a private space. But if you don’t know where to start, here are some prompts to start flexing your writing muscles.

Writing Prompts to Help You Get to Know Yourself Better

When you’re ready, get something to write with and a blank sheet of paper. Here are some prompts you can use to get started:

What does the perfect day look like for you? Think about the activities you’d engage in and who you would be spending your time with. Try engaging your five senses to dive deep into your imagination.
Write a story about the last time you were embarrassed. This time, reframe the experience into a positive one where you learn something new about yourself.
Think about the best piece of advice you've ever received from someone. How has it helped to shape your life?
Write a song or a poem about what it’s like to eat your favorite dessert. Consider the flavors, textures, and how you feel when you eat this specific treat. Where are you eating it? Did someone special make it for you, or did you make it yourself?
What does self-love really mean to you? Who taught you what loving yourself looks like? What have you learned to embrace about yourself?
If you’ve experienced a painful event, free-write about it. Don’t worry about grammar, spelling, or legibility—just write whatever comes to mind. You can even draw if that helps.

These writing prompts should get you more comfortable with expressing your feelings. Once you make sense of your own experiences, you might be ready to share them with friends, significant others, and other people you trust. If you have a therapist or plan to start therapy, you’ll already have some material to share that you can explore in the session.

When you connect through storytelling, you begin to strengthen your support network. Pope shared how much she leaned on her friends after a bad breakup. “ If you have community, lean into it and don't be afraid that someone's gonna judge you if you made a mistake or a bad decision, a poor decision, don't be afraid of that. It's so much more healthy to just let it out,” she says.

Pope also cautions that doing this can also reveal the people who accept you just as you are—flaws included: “ If somebody judges you or tries to make you feel bad about it, then OK, great. That one person is not a safe space for you.”

What This Means For You

If you’re uncomfortable opening up to your friends this way, that’s perfectly fine. Never feel pressured to share some uncomfortable thoughts or experiences. You can keep them to yourself in your journal or reserve them all for your therapist.

Writing is a good place to start when you want to better understand who you are and how your experiences have affected you. If you’re struggling with processing your emotions and feel that you need someone to talk to, consider seeing a mental health professional.

Mugerwa S, Holden JD. Writing therapy: a new tool for general practice? . Br J Gen Pract . 2012;62(605):661-663. doi:10.3399/bjgp12X659457

American Psychological Association. Writing to heal .

Krpan KM, Kross E, Berman MG, Deldin PJ, Askren MK, Jonides J. An everyday activity as a treatment for depression: the benefits of expressive writing for people diagnosed with major depressive disorder . J Affect Disord . 2013;150(3):1148-1151. doi:10.1016/j.jad.2013.05.065

By Ayana Underwood Ayana is the Associate Editor at Verywell Mind, where she aims to publish mental health content that is both engaging and of high quality.

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Ultimate Guide to Creative Writing Therapy (with Writing Therapy Prompts)

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Creative writing therapy, or therapeutic writing is a form of therapeutic intervention that uses writing as the tool to explore and express your thoughts, feelings and emotions. It’s also known as journal therapy – and it’s essentially the art of writing in a journal to heal yourself.

Writing therapy can be a useful tool for people who struggle with mental health, have experienced trauma or grief, or are simply looking for a creative outlet to process their thoughts and feelings. Today we’re going to explore what creative writing therapy is, how it works, and the potential benefits of writing therapy. We’ll also share writing therapy prompts to help you get started and explore writing therapy today.

Please keep in mind that there is no true substitute for seeing a licensed therapist, and if you feel like you could benefit from talking to someone and getting help with what you’re going through – you’re not alone! There are tons of incredible therapists out there to help you. Here at Made with Lemons we’re big advocates for therapy and if you’d like a more inside scoop to our own journey with therapy, join On Your Terms . It’s a wellness newsletter that shares a more inside look to our own wellness journey as well as tools to help you along yours. Learn more about On Your Terms here.

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What is Creative Writing Therapy?

Writing therapy, also known as therapeutic writing, is a form of creative and expressive therapy that involves writing about your personal experiences, thoughts and feelings. It can take many forms, including journaling, poetry, creative writing, letter writing, or memoirs. Writing therapy can be done individually or in a group setting. It can also be facilitated by a therapist, counselor or writing coach.

The purpose of creative writing therapy is to help you express and process your emotions in a safe and supportive environment. It’s helpful to be able to write out your thoughts and feelings that might be hard to articulate in other ways.

You might also see therapeutic writing used to help explore issues that are difficult to discuss in traditionally talking therapy sessions. And when your therapist invites you to try writing therapy, it’s also used in conjunction with other forms of therapy, such as trauma-focused therapy, to enhance its effectiveness.

An example of creative writing therapy could be writing a letter to a person who hurt you, and then shredding or burning the letter to release some of the hurt and anger.

How Does Therapeutic Writing Work?

Writing therapy works by allowing individuals to express their thoughts and feelings in a way that is both private and creative. The act of writing can help you organize your thoughts and gain clarity on your emotions. Writing can also be a way to release pent-up emotions and relieve stress.

For example, if you’re feeling stressed after a long day of work, taking a few moments to write down what’s stressing you out and allowing yourself to let it go, can help you have a calm and more relaxing evening.

Writing therapy should be a truly non judgemental space. It’s a time to write without worrying about grammar, punctuation, or spelling. The goal here is to let words flow freely, without judgment or criticism. Creative writing therapy sessions can be structured or unstructured, and sometimes it’s helpful to use prompts or exercises to help you get started. (i.e. what in your life is bringing you the most anxiety, or writing a letter to your friend to express ___________ hurt you when they said that.)

Oftentimes we find it easier to write about our hurt, our pain and the experiences that caused that, as opposed to opening up to talk about those things. In this way, writing can be a way to explore and process complex emotions such as grief or anger in a safe and supportive environment, where no one can get hurt further by what’s being felt and expressed.

Potential Benefits of Writing Therapy

Now let’s talk about some of the benefits of therapeutic writing.

Improved mental health

Writing therapy can be a tool that helps you manage symptoms of depression, anxiety and other mental health conditions. You can use journaling therapy to express and process difficult emotions, which over time can lead to improved mental regulation and a better sense of control over your thoughts and feelings.

Increased self-awareness

Creative writing therapy can help you gain a better insight into your thoughts and behaviors. By reflecting on your experiences through writing, you can start to identify patterns and gain an understanding of yourself.

Stress relief

Therapeutic writing can be a way to relieve stress and reduce anxiety. Writing is often cathartic, allowing you to release pent-up emotions and start to feel relief from things that would otherwise feel overwhelming.

Improved communication skills

Journal therapy can also help you improve your overall communication skills. When you practice expressing yourself through writing, you can develop more confidence to communicate more effectively in both your personal and professional relationships. In essence, writing your feelings can help you communicate them better when needed.

Increased creativity

Lastly, creative writing therapy can also be a way to tap into your creativity and imagination. We talk a lot about your inner child around here, and journal therapy can be another helpful way you can interact with your inner child. Through writing you can explore new ideas and perspectives, leading to your own personal growth.

How to try Creative Writing Therapy Today

Now let’s talk about how you can try therapeutic writing for yourself today. These tips are going to help you get started with writing therapy from home, as a personal activity to help heal yourself.

Set aside dedicated time for writing therapy

Like most self improvement and self care techniques, it helps to set aside a dedicated time to write regularly. We know this can be a challenging task, especially if you’re struggling with mental health issues or challenges in your life. A good place to start is to set aside a few minutes each evening to write and decompress from your day. It can be just 2 minutes before bed. Remember, therapeutic writing is a non judgemental activity, so the amount of time you dedicate isn’t important, it’s just important to show up for yourself.

Find a quiet and comfortable space

Find a place that’s quiet and comfortable, and where you can write without interruptions. Some people find it helpful to create a writing ritual, such as lighting a candle or playing soft music to create a sense of calm and focus. Find what works for you, in a space where you can be alone for a few minutes.

Choose a writing therapy prompt or topic

At the end of this guide we’re going to share writing therapy prompts to help you explore creative writing therapy and give you a starting point. You can also talk to your therapist to get prompts, or find some online. Prompts can be general, such as “write about what makes you grateful or happy”, while others can be more specific, such as “write about a time that you felt overwhelmed.”

Write freely and without judgment

The most important thing about writing therapy is to write freely, without judging yourself. Allow yourself to write without worrying about grammar, punctuation or spelling. Don’t put a time limit on your writing, or feel like you have to write a certain number of words or pages. The goal here is to allow your thoughts and emotions to flow freely without any judgment at all.

Write honestly and openly

Along with being judgment free, it’s also so important that you write honestly and openly. Writing therapy is a space for honesty and openness. This space is created for you to share your thoughts and emotions, even if they're difficult or uncomfortable to confront. Just be open to exploring them, and remember that you don’t have to share this with anyone, so it’s a space where you can be fully honest with yourself.

Reflect on your writing

After writing, you can take a few moments to reflect on what you have written. It might even be helpful to come back to what you have written at another time, when you have a clear head or have left the emotions behind. This can help you consider the emotions and patterns that you have expressed. Doing this reflection can help you gain more insight into your thinking patterns and emotions for future sessions.

Consider sharing your writing with a therapist or counselor

Lastly, consider sharing your writing with a therapist or counselor. They can help you process emotions and gain a deeper understanding of yourself. Sharing your writing can also help you feel less alone in your struggles and provide important validation for your experiences.

20 Writing Therapy Prompts

When do I feel the most like myself?
How do I feel at this moment?
What do I need more of in my life?
What do I look forward to every day?
What is a lesson that I had to learn recently?
Based on my daily routine, where do I see myself in 5 years?
What don’t I regret?
What would make me happy right now?
What has been the hardest thing to forgive myself for?
What’s bothering me? And why?
What do I love about myself?
What are my priorities right now?
What does my ideal day look like?
What does my ideal morning look like? Evening?
Make a list of 30 things that make you smile
Make a gratitude list
The words I’d like to live by are…
I really wish others knew this about me…
What always brings tears to my eyes?
What do I need to get off my chest today?

Creative writing therapy can be a powerful tool for exploring and processing thoughts and emotions. When you set aside a dedicated time to write, and create a safe and supportive space for yourself, you can gain insight into your emotions and develop better tools to manage them. With practice and commitment, writing therapy can become a habit for your self care routine.

If you’d like to build the habit of writing therapy in your own life, then we’d like to invite you to download our habit tracker. It’s super easy to use, beautifully designed and completely free. All you need is a google account to access it. Grab a copy of our habit tracker here.

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Writing Technique Across Psychotherapies—From Traditional Expressive Writing to New Positive Psychology Interventions: A Narrative Review

Chiara ruini.

Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy

Cristina C. Mortara

Writing Therapy (WT) is defined as a process of investigation about personal thoughts and feelings using the act of writing as an instrument, with the aim of promoting self-healing and personal growth. WT has been integrated in specific psychotherapies with the aim of treating specific mental disorders (PTSD, depression, etc.). More recently, WT has been included in several Positive Interventions (PI) as a useful tool to promote psychological well-being. This narrative review was conducted by searching on scientific databases and analyzing essential studies, academic books and journal articles where writing therapy was applied. The aim of this review is to describe and summarize the use of WT across various psychotherapies, from the traditional applications as expressive writing, or guided autobiography, to the phenomenological-existential approach (Logotherapy) and, more recently, to the use of WT within Acceptance and Commitment Therapy (ACT). Finally, the novel applications of writing techniques from a positive psychology perspective will be analyzed. Accordingly, the applications of WT for promoting forgiveness, gratitude, wisdom and other positive dimensions will be illustrated. The results of this review show that WT yield therapeutic effects on symptoms and distress, but it also promotes psychological well-being. The use of writing can be a standalone treatment or it can be easily integrated as supplement in other therapeutic approaches. This review might help clinician and counsellors to apply the simple instrument of writing to promote insight, healing and well-being in clients, according to their specific clinical needs and therapeutic goals.

Introduction

Writing therapy can be defined as the process in which the client uses writing as a means to express and reflect on oneself, whether self- generated or suggested by a therapist/researcher (Wright & Chung, 2001 ). It is characterized by the use of writing as a tool of healing and personal growth. From the first investigations of James Pennebaker (Pennebaker & Beall, 1986 ), writing therapy has shown therapeutic effects in the elaboration of traumatic events. In recent years, expressive and creative writing was found to have beneficial effects on physical and psychological health (Nicholls, 2009 ).

Currently, clinicians have moved from a distress-oriented approach to an educational approach, where writing is used to build personal identity and meaning through the use of autobiographical writing (Hunt, 2010 ). In this vein, autobiographical writing is becoming a widespread technique, which allows people to recall their life path and to better understand the present situation (McAdams, 2008 ). Moreover, it is observed that individuals often tend to report significant life events (positive or negative) in personal journals (Van Deurzen, 2012 ). Keeping a journal is a way of writing spontaneously: it can be considered a sort of logbook where thoughts, ideas, reflections, self-evaluation and self -assurances are recorded in a private way. Journaling is different from therapeutic writing the writer does not receive specific instructions on the contents and methodologies to be followed when writing, as it happens in therapeutic writing. Nowadays journaling can be done also through online blogs and social network (Facebook). In doing so, a private and spontaneous journal can be shared publically.

Writing techniques are often implemented into talking therapies, since both processes (talking and writing) favor the organization, acceptance and the integration of memories in the process of self-understanding (Lyubomirsky et al., 2006 ). However, expressive writing has been found to be beneficial also as a “stand alone” technique for the treatment of depressive, anxious and post-traumatic stress disorder symptoms (Reinhold et al., 2018 ). In a recent study, it was found that enhanced expressive writing (i.e., writing with scheduled contacts with a therapist) was as effective as traditional psychotherapy for the treatment of traumatized patients. Expressive writing without additional talking with a therapist was found to be only slightly inferior. Authors concluded that expressive writing could provide a useful tool to promote mental health with only a minimal contact with therapist (Gerger et al., 2021 ). Another recent investigation (Allen et al., 2020 ) highlighted that the beneficial effect of writing techniques may be moderated by individual differences, such as personality trait and dysfunctional attitude (i.e., high level of trait anxiety, avoidance and social inhibition). In these cases, therapeutic writing may be even more beneficial since it avoids the interactions with the therapist or other clients.

This article aims to illustrate and summarize the main psychotherapeutic interventions where writing therapy plays an important role in the healing process. For instance, a common application is the use of a diary in standard Cognitive Behavioral Therapy for promoting patients’ self observation (Butler et al., 2006 ). Similarly, other traditional psychotherapies use writing in their therapeutic process: from the pivotal application of writing to understand and overcome traumatic experiences, to the phenomenological-existential approach where writing has the function of giving meaning to events and of clarifying life goals (King, 2001 ), to Acceptance and Commitment Therapy, where writing facilitates the process of thought-defusion (Hayes, 2004 ). This review will also address the novel applications of writing technique to new a psychotherapeutic context: positive psychotherapy where the tool of writing is employed in many effective techniques (i.e. writing gratitude or forgiveness letters). Smyth ( 1998 ) reviewed 13 case-controlled writing therapy studies that showed the positive influence of writing techniques on psychological well-being. The benefits produced in writing activity (self regulation, clarifying life goals, gaining insight, finding meaning, getting a different point of view) can be described under the rubric of psychological and emotional well-being. In accordance with Fredrickson’s Broaden and Build Theory of Positive Emotions ( 2004 ), writing may foster positive emotions since putting feelings and thoughts into words widens scope of attention, opens up to different points of view and allows the mind to be more flexible (King, 2001 ).

Finally, we will describe and explore new contexts where writing activities currently take place: the web and social networks. We will underline important clinical implications for these new applications of writing activities.

Traditional Applications of Writing Techniques

Clinical applications of writing therapy include the method of expressive writing created by Pennebaker (Pennebaker & Beall, 1986 ); the autobiography; and the use of a diary in traditional Cognitive Behavioral Therapy as described in the following sections.

James Pennebaker: The Paradigm of Expressive Writing

James Pennebaker was the first researcher that studied therapeutic effects of writing. He developed a method called expressive writing, which consists of putting feelings and thoughts into written words in order to cope with traumatic events or situations that yield distress (Pennebaker & Chung, 2007 ). In the first writing project, Pennebaker and Beall ( 1986 ) asked fifty college students to write for fifteen minutes per day for four consecutive days. They were randomly instructed to write about traumatic topics or non-emotional topics. Results showed that writing about traumatic events was associated with fewer visits to the health center and improvements in physical and mental health. The experiment was repeated several times with different samples: with people who suffered from physical illnesses, such as arthritis and asthma, and from mental pathologies such as depression (Gortner et al., 2006 ). Individuals with different educational levels or writing skills were examined, but these variables were not found to be significant. At first, studies investigated only traumatic events, but later research expanded the focus to general emotional events or specific experiences (Pennebaker & Evans, 2014 ).

According to Pennebaker, what makes writing therapeutic is that the writer openly acknowledges and accepts their emotions, they become able to give voice to his/her blocked feelings and to construct a meaningful story.

Other therapeutic ingredients of expressive writing concern (1) the ability to make causal links among life events and (2) the increased introspective capacity. The former may be favored through the use of causality terms such as “because”, “cause”, “effect”; the latter through the use of insight words (“consider”, “know” etc.). These emotional and cognitive processes were analyzed through a computerized program (Pennebaker et al., 2015 ) and outcomes showed that the more patients used causation words, the more benefits they derived from the activity. Similarly, using certain causal terms expresses the level of cognitive elaboration of the event achieved by the patient and may indicate that the emotional experience has been analyzed and integrated (Pennebaker et al., 2003 ). Thus, the benefits of writing stem from the activity of making sense of an emotional event, the acquisition of insight about the event, the organization and integration of the upheaval in one’s life path.

Moreover, expressive writing allows a change in the way patients narrate life events. Many studies have highlighted that writing in first or third person alters the emotional tone of the narration (Seih et al., 2011 ). It is common for people who have experienced a severe traumatic event to initially narrate it in the third person and only later, once the elaboration and integration processes have set into motion, are they able to narrate their experience in the first person. This phenomenon occurs because third person narration allows the writer to feel safer and more detached from the experience, while first person perspective reminds them that they were the protagonist of the trauma. While writing using the third person can be easier in the wake of a traumatic event, writing in first person has been demonstrated to be more effective in the elaboration process (Slatcher & Pennebaker, 2006 ).

Another issue examined by Pennebaker and Evans ( 2014 ) concerns the difference between writing and talking about a trauma. In expressive writing, an important element consists of feeling completely honest and free to write anything, in a safe and private context without necessarily share the content with a listener or the therapist. Conversely, talking about trauma implies the presence of a listener, and the crucial aspect lies in the listener’s capability to comprehend and accept the patient’s narrative. Moreover, the interactions with a therapist could be particularly stressful for individuals with high levels of social inhibitions and trait anxiety (Allen et al., 2020 ).

Writing Techniques for Addressing Trauma

Writing is considered a therapeutic strategy to cope with life adversities thanks to the positive effects of putting feelings and thoughts into words. There are various writing techniques used as therapeutic strategies to cope with a trauma which are described in Table Table1 1 .

Writing approaches in clinical interventions

What the aforementioned writing therapies all have in common is a theoretical underpinning: the act of writing as a means to modify one’s life story and reframe elements which survivors want to change. Creating stories and thinking of ways to alter them may emphasize on one hand the possibility of a real change to occur, and on the other, the active role of the individual in their own life (Sandstrom & Cramer, 2003 ). In this way, writing can be also defined as a process of resilience: putting negative feelings into words can spark the search for solutions, with the consequence of having a positive attitude towards life challenges and promoting personal growth.

Besides the numerous positive effects of writing, there can be situations in which writing does not work, or when it can actually cause negative side effects. An example of said situation is when an individual has to deal with issues that arise intense painful emotions. In this case, writing can cause crying, very low mood, or even a breakdown (Pennebaker & Chung, 2007 ). This may occur because analyzing a traumatic experience may trigger a process of cognitive rumination, which is considered a specific symptom of PTSD (Pennebaker & Evans, 2014 ).

In conclusion, the paradigm of expressive writing is frequently used in patients who have had distressing experiences. Writing about traumatic experiences can help to elaborate negative emotions connected to the upheaval, to construct a narrative of the event, and to give it a meaning. However when client’s levels of distress are very intense and/or they are maintained by cognitive rumination, it is not advisable to undergo a writing exercise.

McAdams: The Use of Autobiography in the Construction of Self-identity

Writing therapy has also been shown to have benefits in constructing self-identity (Cooper, 2014 ). An important pioneer of this method, Dan McAdams, developed a life story model of identity, which postulates that individuals create and tell evolving life narratives as a means to provide their lives with purpose and integrity (McAdams, 2008 ). Identity is an internalized story that is composed by many narrative elements such as setting, plot, character(s) and theme(s). In fact, human lives develop in time and space, they include a protagonist and many other characters, and they are shaped by various themes. Narrative identities allow one to reenact the past, become aware of the present and have a future perspective. Individuals construct stories to make sense of their existence, and these stories function to conciliate who they are, were and might be according to their self-conception and social identity. Biography, for example, is a written history of a person’s life; it deals with the reconstruction of a personal story in which salient events are selected and told. The therapeutic power of biographies entails the act of selection of worthy events that characterize a person’s life (Lichter et al., 1993 ).

In the same way, the autobiography can be an instrument to create a written life story. The first therapeutic effect is the possibility to define a sense of identity through autobiographical narratives by the identification of significant personal changes and by giving meaning to them. According to Bruner ( 2004 ) writing an autobiography allows the clients to recognize themselves as the authors of their experiences (sense of personal agency).

Another therapeutic ingredient of autobiography is the process of conferring stability to autobiographical memories: people often misremember details of events over time or are influenced by distortion mechanisms (McAdams, 2008 ). Autobiography is useful not only to code every event of self-story, but also it is beneficial for integrating different experiences and for analyzing the life trail, highlighting both continuity and changes. McAdams studied the use of autobiography in life changes, by employing a written procedure, the “Guided Autobiography” (McAdams et al., 2006 ). This is a therapeutic technique aimed at investigating the relationship between the continuity of story themes and personality changes. In the span of ten two-hour sessions, which take place once a week, participants are asked to think and describe the most important events of their life, referring to a specific life theme (i.e. family, money, work, health, spirituality, death, aspirations). Reker et al. ( 2014 ) underlined that Guided Autobiography is an effective method to enable participants to understand and appreciate their life stories, which also increases optimism and self-esteem. In conclusion, Mc Adams technique of guided autobiography entails different therapeutic ingredients: it allows to connect life events and personal memories, and to underscore the process of continuity among them. At the same time, significant life changes are emphasized, and the individual can improve the sense of agency in understanding his/her role as a protagonist of his/her life. Thus, guided autobiography could enhance personal well-being and meaning in life.

The Use of the Diary in CBT

Considering that Cognitive-Behavioral Therapy (CBT) works on thinking patterns, maladaptive thoughts and dysfunctional behaviors (Butler et al., 2006 ), the diary is a very useful instrument of self-observation. It entails a written exercise in which the client is asked to take note of when and where a stressful situation occurs, the automatic thoughts it elicits, the connected emotions and the consequent behavior. This technique was developed by Aaron Beck at the early stages of cognitive therapy for anxiety and depression (Beck, 1979 ). In writing this diary the writers learn to pay attention to their functioning and acquires self-awareness about their problematic issues (King & Boswell, 2019 ). According to traditional CBT method, the therapeutic ingredients of writing the structured diary consist of helping clients to increase their awareness of automatic thoughts and beliefs, which are influencing their emotions and behaviors. The diary then allows the processes of cognitive restructuring, where negative, automatic thoughts are analyzed and modified in order to achieve a more realistic attitude toward life events and problematic situations (Beck, 1979 ). Thus, writing techniques within CBT consist of keeping a structured diary, which is supervised by the therapists along the various phases of the therapeutic process. The diary in CBT is specifically aimed at addressing symptoms and distress, but it can also trigger cognitive changes, maturation and improved self-awareness at the end of the clinical work (Butler et al., 2006 ).

Existential Approaches: The Bridge Between Clinical Psychology and Positive Psychology

Logotherapy.

Logotherapy is a specific strategy within phenomenological-existential therapies. It relies on a therapeutic paradigm created by Viktor Frankl (Frankl, 1969 ) and based on existential issues. Logotherapy is an entirely word-based treatment. Its tenets assume that life always has meaning, even in the most adverse circumstances and that people always strive to find a personal meaning in their existence (assumption of will to meaning). From this perspective, a journal can be considered a place where people find a meaning in life-threatening events and transform implicit and negative experiences into expressive and positive ones. In fact, Logotherapy emphasizes the importance of words in creating a meaning and, in this case, writing techniques are particularly appropriated to this task. The client is asked to narrate adverse life events using words and sentences that help him/her to acquire a sense of meaning and acceptance.

In phenomenological-existentialist psychotherapies, writing assignments are used to increase clients’ awareness of their limitations and to create an opportunity to reflect on both life and death (Yalom, 1980 ). Specifically, in the exercise of Writing your Epitaph, the client is encouraged to think and write what people would say in their memory. This task aims at clarifying personal values and at committing to them. This allows the identification of the direction individuals want to give to theirs life and to verify if they really are acting towards those goals. The main difference between logotherapy and guided autobiography relies on the philosophical framework used in existential approach, which is not present in Mc Adams paradigm. Furthermore, in logotherapy the narrative topic might be narrowed to a specific traumatic event, not necessarily involving all personal biography. The therapeutic ingredients of logotherapy, thus, concern the increase in life meaning and the possibility of reframing and processing existential issues as death, evil and trauma in individual’s life experiences.

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) focuses on the acceptance of unchangeable things and on the integration of different interventions (including strategies of mindfulness) with the aim of increasing psychological flexibility and promoting an active attitude towards problematic matters (Hayes, 2004 ). ACT is based on a rigorous cognitive analysis, the Relational Frame Theory (Reese, 2013 ). This theoretical frame posits that language and cognition allow humans to have the ability to learn to relate events under arbitrary contextual control. This framework particularly analyzes paradoxes, metaphors, stories, exercises, behavioral tasks, and experiential processes (Hayes, 2004 ). This approach has studied a particular mechanism called “Thought Defusion” (Hayes, 2004 ) which deals with the ability to distance one’s self from problematic thoughts. Frequently, individuals cannot see problems because they are “fused” with them. The defusion techniques allow the individual to distance themselves from problems and see them from a more detached perspective (i.e., the helicopter perspective exercise). In this way, patients have the possibility to identify a problematic issue, accept it and find a manner to live with it, which can decrease the level of suffering (Hayes, 2004 ). Thus, the act of writing can be considered as a way to keep distance from one’s own thoughts and feelings in order to be able to modify the behaviors and life choices according to one’s values and priorities.

The first part of this article identifies how the traditional use of writing techniques has been analyzed within different forms of psychotherapy. The subsequent part of this review will describe the application of similar writing techniques within the framework of positive psychology. In particular, the use of expressive writing, journaling or other structured writing techniques will be described as ways to promote personal well-being, personal growth, gratitude and positive emotions in general.

Positive Psychotherapy

Unlike the traditional deficit-oriented approach to psychotherapy, Positive Psychotherapy aims at considering with a similar standing, symptoms and strengths (Rashid & Seligman, 2018 ).

Positive Psychotherapy uses writing techniques in various moments of the therapeutic process (see Table 2 ). For instance, at the beginning of the therapy clients are invited to write a personal presentation in positive terms. This exercise is called “ Positive Introduction” (Rashid, 2015 ). The importance of this exercise lies in the fact that while writing a self-presentation clients highlight their positive characteristics and qualities and they may also recall and describe a particular episode when these strengths were manifested. This initial writing assignment, thus, may foster patients’ self-esteem and self-awareness of positive personal characteristics. In the middle phase of the positive psychotherapy, therapists can suggest the “ Positive Appraisal” activity to their clients. This consists of thinking and writing down resentments, bad memories and negative events which have occurred in their past and that still affect their life. Clients are asked to reframe these past negative events and to search for possible positive consequences in terms of meaning or personal development. The final phase of therapy focuses on exploring and training the individual’s strengths. The exercises proposed in this phase include writing assignments such as “ Gift of Time” and “ Positive legacy”, where the therapist asks clients to write how they would be remembered by significant others and future generations. “ Positive Legacy” is focused on the positive connotations of writing and often it is associated with planning a “gift of time activity” that puts these positive characteristics into practice (Rashid, 2015 ). This technique entails similarities with logotherapy and ACT epitaph exercise, but in PPT the client is guided to emphasize positive aspects of their life and personal qualities, and there is no mention to relational frame theory as in ACT.

Writing approaches in positive intervention

Furthermore, Positive Psychotherapy entails also specific writing techniques devoted to the promotion of specific positive emotions, such as gratitude, forgiveness and wisdom, as described below.

Gratitude is a feeling of appreciation for people or events, which is triggered by the perception of having obtained something beneficial from someone or something (it can be also an impersonal source, such as God or Nature) (Rashid & Seligman, 2018 ). Written exercises of gratitude can be divided into Gratitude Letter, Gratitude Journaling and “ Good versus Bad Memories” .

Gratitude Letter consists of writing and delivering a gratitude letter to a person that the client has never sincerely thanked. This intervention aims at strengthening the client’s relationships and enhancing their social well-being (Lambert et al., 2010 ). In Gratitude Journaling, clients are asked to write three good things which have happened to them during the day (Rashid, 2015 ).

Many studies showed that thinking about memories of gratitude in a written form promotes well-being and increases positive mood because writing allows one to give shape to positive experiences (Toepfer et al., 2012 ; Wong et al., 2018 ). In fact, in gratitude writings individuals are more likely to express positive feelings and have high level of insight, making gratitude letters or journaling a powerful tool to produce not only well-being, but also health improvements (Jans-Beken et al., 2020 ).

Difficulties in writing a gratitude letter relate to the interpersonal nature of this task, because being grateful towards someone entails being dependent on that person and, in turn, this can invoke a sense of vulnerability that makes the writer feel not at ease (Kaczmarek et al., 2015 ). In this way, the psychological costs of writing a gratitude letter are greater than expressing it in a private journal. Another important element of difference pertains the delivery of the letter as the gratitude journal has a personal use, while the letter is written to be delivered to someone. The main risk of writing a letter to someone refers to the possibility of not being accepted or feeling judged by the reader. For this reason, recently, positive therapists may ask their clients to write the letter, without necessarily have it delivered to the recipient. Thus, the benefits associated with a gratitude letter exercise are not necessarily connected with the act of delivery, but are placed in the writing itself (Rash et al., 2011 ).

In addition to gratitude letter and journal, Good versus Bad Memories is a writing activity which has the therapeutic effect of helping clients to understand how anger, bitterness and other depressive symptoms may influence clients’ life and how they can stop these processes by focusing on positive memories and experiences (Rashid & Seligman, 2018 ).

These three writing activities on gratitude are useful in order to emphasize good things that usually are taken for granted. Furthermore, they may downregulate the impact of negative emotions or negative experience in life. (Lyubomirsky & Layous, 2013 ).

Forgiveness

Forgiveness implies a situation of offense where a person makes the choice of letting go of anger and of searching for a compassionate attitude towards the transgressor (Thoresen et al., 2008 ).

Evidence shows that writing about an interpersonal conflict can decrease the level of negative effects in relational conflicts (Gordon et al., 2004 ). The act of writing a forgiveness letter includes a cognitive processing that promotes emotional regulation, the expression of affect and gaining insight. Positive Psychotherapy uses forgiveness exercises in order to transform feelings of anger and bitterness into neutral or positive emotions (Rashid, 2015 ). For example, clients are asked to write a letter where they describe an experience of offence with related feelings and then the promise to forgive the guilty person. McCullough et al. ( 2006 ) found that victims of interpersonal transgressions could became more forgiving toward their transgressors when they were asked to write about possible beneficial effect of the transgression, compared with victims who wrote about traumatic or neutral topics. Thus, the positive narrative approach may facilitate forgiveness and help victims to overcome traumatic interpersonal issues.

As for gratitude letters, the delivery of forgiveness letters is a crucial issue, because the act of showing forgiveness can influence the process of forgiveness itself. In some cases, as highlighted in Gordon and collaborators’ study ( 2004 ) about marital conflicts, writing and delivering a letter is helpful to reduce relational tension and the consequent conflicts, but in other situations where forgiveness remains an intra-personal process, sharing it can be more harmful than beneficial. This may occur particularly when the relationship between victims and transgressors is particularly problematic (or even abusive) and reconciliation is not possible, or not recommendable (Gordon et al., 2004 ).

Forgiveness writing is also helpful in the promotion of self-forgiveness. Jacinto and Edwards ( 2011 ) describe a case where the exercise of writing a letter was used in the therapeutic process of self-forgiveness. The act of writing helped the client to trigger self-empathy and consequentially to let go of negative beliefs about herself.

In conclusions, the therapeutic ingredients of these writing assignments (gratitude and forgiveness letters) concern both an intra-personal dimension (the promotion of self-esteem, self-awareness and a sense of meaning in life) and an interpersonal dimension (the promotion of empathy, compassion, and a sense of connectedness with others). They both constitute the pillars of well-being and positive psychological functioning (Lyubomirsky & Layous, 2013 ).

Wisdom is a complex ability composed of cognitive and emotional competences, such as perspective-taking, thinking with a long-term perspective, empathy, perception and acceptance of emotions (Staudinger, 2008 ). Collecting narratives of wisdom may be connected with autobiographical memory (McAdams, 2008 ). Glück and collaborators ( 2005 ) conducted a study where participants had to write a 15 line paragraph describing all the situations where they did, thought or said something wise; then they had to select a situation from them where they had been wise. This writing task was followed by an interview in which the “wise situations” were discussed. Writing about autobiographical memory kindles the development of strengths related to wisdom, such as acceptance and forgiveness of others, taking different perspectives, being honest and responsible and making compromises.

The promotion of wisdom can be done also using specific narrative structures, such as the one of storytelling and fairytales. The employment of fairytales with adults was found to promote the development of feelings of wisdom (Ruini, 2014 ; Ruini & Ottolini, 2014 ). Fairytales, in fact, enable a process that allows one to reformulate problems in narrative terms, using a specific narrative plot. It consists of three main steps: (1) the identification of an initial stressful event; (2) the journey of the protagonist, with tests and adversities to face; (3) the final positive resolution (happy ending) (Masoni, 2019 ). Furthermore, Ruini and Ottolini ( 2014 ) showed the effectiveness of using fairytales in patients who had to cope with life transitions: to read and then to re-write a fairytale is a way to symbolize one’s own life and clarify moral and existential issues. In this particular narrative technique, the patients are asked to write a fairytale that well symbolizes their life, with a happy ending; the fairytale created is then read and discussed in the session. In many cases, the stories contain narrative issues and characters’ attitudes that evidence patients’ real difficulties. For example, the protagonist can be very passive in the story or not well characterized. The clinician helps the patient to re-write the fairytale making corrections that allow the patient to clarify dysfunctional elements and consequently to construct a new and more positive story. Creating a happy ending can be a way to express patients’ desires about their future and to let them imagine how they can be satisfied with their life. Through the exercise of writing a structured fiction story, patients can analyze their life situations in a more detached way, view problems from a different perspective and become aware of their values and attitude. This emotional detachment is similar to the process of cognitive defusion in ACT, but in this case, there is no mention to the relational frame theory, and the act of writing the fairytales may promote another positive dimension: creativity (Ruini et al., 2020 ).

Writing can be considered as a coping strategy aimed at finding solutions which in turn can spark hope in desperate situations. In line with the expressive writing approach (Pennebaker & Evans, 2014 ), writing about traumatic or particularly painful situations, may promote feelings of hope because it allows to go beyond suffering and to reach positive perspectives.

Positive psychotherapy entails specific written exercises that focus on strengthening hope. Among these, we can find Writing about Best Possible Selves, where possible selves are personal representation of goals, connected with what people desire for their future. This writing exercise aims to improve self regulation because it allows clients to clarify and restructure priorities and acquire insight on one’s own motivations and values (Loveday et al., 2018 ; Sheldon & Lyubomirsky, 2006 ). Other potential benefits of writing “best possible selves” are the possibility of integrating life experiences, identifying the meaningful ones, and gaining a sense of control (Lyubomirsky & Layous, 2013 ). These benefits have also been confirmed in King’s ( 2001 ) study where participants were invited to write for four days (20 min per day) a narrative description of their best possible future selves. Outcomes showed that, compared to writing about other topics, the act of thinking and describing oneself as best as possible increased positive mood and decreased distress five months later.

Another technique to foster hope is the Blessing journal/Three Good Things in which patients keep a journal where they write three good things every night and the reason why they think those things have happened. The objective is not only to identify positive happenings, but also to search for the causes and underline the active role of the subject in provoking them. The sense of personal agency in fact, is considered a component of hope (Snyder et al., 2000 ). Snyder’ hope therapy (Snyder et al., 2002 ) entails the specific use of “hope narratives” where clients are guided in a process of writing past experiences where they were able to achieve significant personal goals (hope reminding exercise). In the subsequent phase of hope therapy, clients are asked to write specific narrative where they focus on future goals to be achieved and they develop specific path to reach them (hope building techniques).

In conclusion, the traditional use of writing techniques within psychotherapies has been included also in the positive psychology perspective. However, positive psychotherapy and other positive interventions have changed the focus of the writing exercises from negative/traumatic experiences to positive ones (Lyubomirsky et al., 2006 ). The therapeutic process may be the same, but the focus is shifted from symptoms to well-being. The positive psychology approach promotes writing exercises on gratitude, hope, forgiveness, and positive descriptions of oneself with the intention of improving clients’ well-being. At the same time, these exercises may help them to process also negative emotions and traumatic events (McCullough et al., 2006 ). Conversely, in traditional psychotherapies (as described in the first part of this article) writing techniques are specifically aimed at overcoming negative events and psychological symptoms. As a byproduct, they may also favor patients’ recovery, well-being and meaning in life, but this was not their main therapeutic purpose.

New Applications: Writing on the Web

The final part of this review deals with other recent modifications of writing approaches that entail the use of internet and other digital technologies. In recent years the act of journaling and keeping a diary has been often replaced with writing in blogs or on social networks such as Facebook, Twitter or Instagram. On these platforms users may create personal profiles that reflect their sense of identity or positive introduction. User profiles also include the narration of their meaningful experiences via photos, videos or boards. In this section we will describe these phenomena and their relation with the psychotherapy process, underlying both the positive and negative features.

Writing activity has been recently modified by the use of the web and by the influence of technological instruments. In fact, social networking sites constitute a technological tool for self-revelation which gives the opportunity to share experiences and impressions through writing as they can create a permanent record of one’s actions or thoughts (Sauter, 2013 ). In social-networks the personal home page is both a space of identity construction and of self presentation towards the rest of the world (Sorapure, 2003 ). In particular, Facebook can also be considered an online autobiographical instrument that codes and keeps track of events of in one’s life.

In this way, unlike traditional handwriting, writing on the web implicates a social function rather than a private one. Sharing, in fact, is a fundamental component of self-writing on the web.

Additionally, the presence of clinicians in social networks is a relevant factor: some therapists can use social networks as an extra instrument to give support or be available for patients. Taylor et al. ( 2010 ) observed that the client–psychotherapist relationship can be influenced by the presence of the psychologist on the Internet. Many psychotherapists create a web site where clients can find their professional activities and services. Other psychologists let clients contact them via e-mail or instant messaging when they need help (Manfrida et al., 2017 ). For example, “Talkspace” is a web platform which offers online therapy through messaging with a licensed therapist. Hull and Mahan ( 2017 ) studied the effectiveness of Talkspace’s text-based therapy and showed the beneficial effects that text therapy had on symptom reduction and improvement in psychological well-being. The study participants also reported high levels of satisfaction with the treatment.

Moreover, Sloan et al. ( 2015 ) have studied the efficacy of a structured writing therapy conducted via internet: “Interapy”. It consists of a protocol of 10 writing sessions, held twice a week, in which patients who suffered from post-traumatic stress disorder had to write about the traumatic event focusing on cognitive reappraisal and sharing details with someone close. A trained therapist then gave feedback on every written online narrative.

Recently Botella et al. ( 2017 ) presented a new instrument, which utilizes digital technology and virtual reality via web in a framework of positive interventions. They named it “Book of Life” and it consists of a personal digital diary composed of various chapters in which some narrative exercises are proposed. Participants may also include multimedia contents (i.e. pictures, videos, music) about a specific topic, in order to create a final positive autobiographical narrative. The therapeutic aim of the Book of Life is to foster positive emotions and the use of personal psychological resources. The results of clinical trials where the Book of Life was applied were particularly effective with older adults and cancer patients.

In conclusion, writing on the web involves different types of interventions. These techniques appeared to be particularly useful during the lockdown due to the Covid-19 pandemic. The use of online platforms and the possibility to contact therapists via mail or social network allowed the delivery of mental health treatments during a global stressful experience (González-Robles et al., 2021 ). Future investigations are needed to explore how writing in websites and social networks may influence the development and the delivery of psychological therapies, both the traditional and the positive ones.

Conclusions

Considering the various and different applications, writing therapy constitutes a very adaptable technique to be used as a standalone treatment or as a supplement of other therapies. WT may provide beneficial effects on symptoms and also on psychological well-being. In fact, the act of writing showed great potential in the promotion of personal strengths, resilience and post-traumatic growth (Sandstrom & Cramer, 2003 ). Moreover, writing techniques can be considered a tool of continuity from the traditional approaches to the new psychotherapy contexts, such as positive psychology and the employment of digital technologies in psychotherapeutic settings.

In general, although it is common sense to think that psychotherapy is for the majority orally communicated, the act of writing provides many benefits in psychotherapeutic sessions as well as in clients’ daily life. Writing makes thoughts more real and transforms mental states in something concrete as feelings, whereas thoughts and reflections expressed orally can easily disappear when the psychotherapy session ends. Moreover, writing therapy may be particularly effective for individuals with high levels of interpersonal avoidance or social inhibition, since they have a therapeutic tool for managing their difficult emotions, without the burden of a direct interaction with the therapist (Allen et al., 2020 ).

However, some caution is needed also when applying writing techniques within psychological interventions. First, the use of writing technique may give thoughts more emphasis and power, specifically when writing negative thoughts or feelings. In this case, the act of writing may increase cognitive rumination (Pennebaker & Evans, 2014 ). The same potentially negative effect of writing thoughts and life experiences may apply also to positive issues. Lyubomirsky et al. ( 2006 ) found that individuals who were asked to write about their happiest moments experienced reduced well-being. The author suggested that the analytic nature of writing about positive events may be counterproductive as opposed to the unorganized process of simply thinking about them.

Another possible side effect of writing techniques (both documented for traditional psychotherapies and positive interventions) is the sense of shame that can be triggered when someone else reads the writing. This could imply a resistance to the act of putting down negative thoughts or the worsening of worries because of the excessive interpersonal exposure (Pennebaker & Evans, 2014 ). In these cases, it is recommended that the use of writing may remain confidential, or it may be accompanied by specific psychological support, so that negative emotions can be discussed with the therapist.

Similar issues of shame and embarrassment have been found to occur when writing and delivering gratitude letters: some studies (Boehm et al., 2011 ; Layous et al., 2013 ; Shin et al., 2020 ) underlined the specific influence of cultural issues: in collectivist cultures (vs individualistic ones) expressing gratitude resulted less effective on well-being because of the sense of indebtedness and embarrassment it can provoke. In fact, the sense of self-improvement and personal agency, which were emphasized in writing assignments, increased life satisfaction only in Western individuals. Conversely, collectivist cultures consider self-focus and individual goals in a less positive way, since they may interfere with the need of the group. Thus, when working with clients belonging to collectivistic cultures, clinicians should use caution in prescribing writing assignments (such as gratitude and forgiveness letters) that can interfere with clients’ relationships within the community they belong to. However, the beneficial effect of writing can be preserved, if the delivery of the letter is not mandatory (Lyubomirsky et al., 2006 ; Pennebaker & Evans, 2014 ).

In conclusions, this review of the literature briefly described writing techniques within psychological therapies, that encompass several different methodologies and specific exercises, ranging from unstructured journaling to personal autobiography, to recalling specific memories associated with positive and/or negative experiences, to writing fairytales, short stories, or letters of forgiveness and gratitude, etc. All these methodologies could be easily implemented in many psychotherapeutic approaches, from the traditional CBT, logotherapy and existential therapies to novel approaches, such as positive interventions. Although some authors found certain potential side effects of writing techniques on the emotional well-being of patients (Lyubomirsky et al., 2006 ), a large body of literature confirmed their beneficial effects, which amplify and prolong the therapeutic effect of the talking therapy with the clinicians. Importantly, adding writing techniques to talking therapies was found to reduce the length of treatment and improve access to psychological therapies (Gerger et al., 2021 ; Pennebaker, 2018 ). The integration of writing techniques within traditional talking therapies or new positive interventions could be easily done also using technological devices, such as app, emails, on line journals or social networks (Botella et al., 2017 ) which could be more appealing for younger patients. The technological tools of communication are changing the role of therapists, who more often use on line resources to support their clinical work. Furthermore, the pandemic due to the Covid 19 and the need to implement telepsychology and distant mental health interventions make the integration of writing techniques particularly appropriate in these settings.

A final recommendation concerns the selection of writing exercises and the timing to prescribe them during the therapeutic process. Different writing activities could yield different effects according to patients’ clinical status and emotional balance. Certain activities could be used to deal with specific clinical problems, such as overcoming traumatic events or personal transgressions, and should be prescribed when the patient complains some of these issues. Other writing activities, on the other hand, have an unspecified theme, (i.e., guided autobiography, or writing your own epitaph) and they appear to be more appropriate for promoting personal growth, personal awareness and existential well-being. These activities may be well suited for the concluding part of the psychological treatment, independently of patient’s initial symptoms and problems. Research on positive interventions (Lyubomirsky & Layous, 2013 ) documented the need to consider the extent to which the therapeutic activity matches an individual’s preference and characteristics (i.e., “person × intervention fit”) in order to maximize the beneficial effect of the intervention on happiness and well-being. Similarly, Joseph ( 2015 ) suggested that therapists should follow their clients preference and should co-create with them a specific treatment agenda, unique for that client, instead of referring to a set of pre-determined list of activities (in this case writing assignments). This would be a more flexible and creative therapeutic approach, in line with a positive clinical psychology perspective (Ruini, 2017 ). However, only further clinical research should test and verify the most effective approach in prescribing writing assignments during the course of psychological interventions.

Acknowledgements

The Authors express their gratitude to Dr. Lorenzo Angiolucci for his contribution in the process of writing and revising this manuscript.

Open access funding provided by Alma Mater Studiorum - Università di Bologna within the CRUI-CARE Agreement.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Writing therapy: types, benefits, and effectiveness, thc editorial team august 7, 2021.

Lady Seated at a Table (recto); Dancing Figures (verso), George Romney, 1775 or later, The Metropolitan Museum of Art (article on writing therapy)

In this article

What Is Writing Therapy?

How does writing therapy work, types of writing therapy, potential benefits of writing therapy, conditions treated by writing therapy, summary and outlook.

Writing therapy, or “expressive writing,” is a form of expressive therapy in which clients are encouraged to write about their thoughts and feelings—particularly those related to traumatic events or pressing concerns—to reap benefits such as reduced stress and improved physical health. 1 Writing therapy may be used in many environments, including in person or online . It may be supervised by a mental health professional or even occur with little or no direct influence from a counselor. There are several types of writing therapy, including, but not limited to narrative therapy, interactive journaling, focused writing, and songwriting. Although traditional psychotherapy , or talk therapy, has been standard practice in many therapeutic and counseling environments, evidence shows that writing therapy has many potential physical and psychological health benefits. 2

What Is the History of Therapeutic Writing / Expressive Writing?

Humans have expressed belief in the healing power of the written word since ancient times. For example, in the fourth century B.C.E., certain groups in Egypt believed that ingesting meaningful words written on papyrus would bring about health benefits. Words were thought to have medicinal and magical healing powers, so much so that inscribed above Egypt’s famed library of Alexandria was the phrase “The Healing Place of the Soul.” 1

However, the roots of modern therapeutic writing may be found in bibliotherapy , a form of therapy that employs literature and reading to help people deal with challenges in their own lives. 3 This practice dates back to the fifth century B.C.E. when it was thought to cure a condition called melancholia, or a deeply experienced depression .

More recently, writing therapy gained momentum in the United States in the early 19th century, 1 and it was popularized in the early 20th century with psychoanalyst Sigmund Freud’s Creative Writers and Day Dreaming. Though talk therapy was still the go-to approach, writing therapy gained steam in the 1930s and 1940s as creative therapies involving the arts , such as music, dance, and writing grew. The 1965 American Psychological Association (APA) convention, held in Chicago, Illinois, hosted a symposium that focused on written communications with clients. This symposium, organized by a division of the APA called Psychologists Interested in the Advancement of Psychotherapy, generated a boom in writing therapy research in the 1970s. 1

In the 1980s, social psychologist James Pennebaker emerged as a leading advocate and researcher of writing therapy. His research focused on the benefits of writing about or discussing one’s emotional disturbances, including reduced stress and improved immune function. He also claimed that writing about traumatic events could help people cope. His work helped propel writing therapy into the mainstream of psychotherapeutic practice. 1

There are two main theories as to how writing therapy works. The first posits that inhibition or suppression of emotions , traumatic events, or aspects of one’s identity constitutes a long-term, low-level stressor and has adverse health effects, such as an increased likelihood of becoming ill. Writing therapy can serve as an act of disclosure, and of written emotional expression, and therefore remove the stressor. However, this theory has become less accepted because research has shown that different acts of expression do not reap the same health benefits as writing therapy. 4

For example, Pennebaker conducted a study in 1996 in which one group of participants was asked to express a traumatic experience through physical movement, and another group was asked to express themselves through both physical movement and writing. Only the group that used both movement and writing showed significant physical health improvements. Pennebaker found that the specific language used while writing is associated with the physical and mental health benefits. When people’s emotional writing compositions were analyzed by judges and by the Linguistic Inquiry and Word Count software, positive emotion words like “happy” and a moderate number of negative emotion words like “sad” were associated with good physical health, while high and low levels of negative emotion words were associated with poor physical health. Compositions that showed an increase in causal words like “reason” and insight words like “realize” showed the most improved physical health in their writers. 4

When engaging in writing therapy, clients are asked to write about a traumatic experience. A standard practice might involve writing for 15 to 20 minutes for three consecutive days. 5 A 2002 study published in the Annals of Behavioral Medicine found that of three groups assigned to journal for one month, the group asked to write about “cognitions and emotions related to a trauma or stressor” enjoyed the most benefits of writing therapy; they had a better perspective on the stressful experience about which they wrote. 6

Sometimes this practice is self-generated. The act of journaling has increased in popularity, especially with the growth of aesthetic practices such as bullet journaling, which combines a journal, calendar, and planner. 7

Photo by Brent Gorwin on Unsplash

There are several types of writing therapy, which generally fall into two categories: writing therapy conducted with the guidance of a mental health counselor and self-motivated writing therapy, the latter of which anyone can take up at their own pace.

A counselor or mental health professional might use writing therapy with clients who find it difficult to verbalize their thoughts or emotions. Narrative therapy, a form of writing therapy that clients and therapists can use together, is often helpful in this situation. 8 Narrative therapy involves the client and mental health professional “reauthoring” a traumatic or problematic story from the client’s life. 9 This method helps the client recontextualize their experience by removing the assumptions and context they have assigned to it to see it from a more objective perspective. 8

Another common format, which can be practiced with or without the guidance of a mental health professional, is called interactive journaling. It combines aspects of writing therapy and bibliotherapy. In interactive journaling, clients are provided with a journal prompt, or a starting point, which they then use to inform their writing. This method is especially effective in substance abuse treatment because it can educate patients and promote reflection and exploration of their experiences. It can also benefit students in the health care field because it can help them empathize with and understand their clients’ experiences. 1

Two other types of writing therapy are focused writing and songwriting. Focused writing incorporates worksheets that educate and guide clients, 10 and songwriting combines music therapy and writing therapy to provide clients with an avenue to reminisce and express their emotions. 11

Researchers have found that expressive, or therapeutic writing, can have numerous physical and psychological health benefits, some of which include: 1

better immune function
fewer doctor visits
less stress
improved grades in school
reduced emotional and physical distress
decreased depression symptoms
lower blood pressure
improved liver function
fewer missed days of work
strengthened memory

In addition to its general benefits, writing therapy has been an easily accessible resource to treat people with many different conditions and stressful or traumatic experiences.

Posttraumatic Stress Disorder

Evidence suggests that writing therapy can posttraumatic stress disorder (PTSD) symptoms and the symptoms of depression often associated with PTSD. The potential effectiveness of writing therapy in helping people cope with trauma makes it a useful alternative when more traditional modes of therapy are ineffective or impossible to access. 12

For example, a study published in 2013 in the Journal of Sexual Medicine used writing therapy to treat 70 women who had experienced childhood sexual abuse. Researchers asked the women to write about trauma or sexual schema (the “cognitive generalizations” someone has about their sexual selves, informed by prior sexual experiences) during five 30-minute sessions, which occurred over up to five weeks. 13 At three different intervals—two weeks, one month, and six months—the study participants were asked to complete interviews and questionnaires regarding their sexual function, PTSD, and depression. Researchers found that between pretreatment and posttreatment, participants reported fewer symptoms of PTSD. According to study findings, participants who wrote about sexual schema were also more likely to recover from sexual dysfunction. 14

Some studies have found that engaging in writing therapy can help reduce anxiety . 15 , 16 In a study conducted in 2020 by faculty of Tabriz University of Medical Sciences in Iran, researchers administered three writing therapy sessions to pregnant women, plus two telephone calls between the sessions and basic pregnancy care, over four to six weeks. During the first session, the women were asked to write about their concerns regarding pregnancy and brainstorm solutions that would help relieve the anxiety they induce, and the phone calls encouraged them to follow through with the solutions. In the second session, researchers employed narrative therapy techniques and asked the women to write a story that outlined their concerns about pregnancy and then applied the solutions they had previously generated. The final session fostered a group discussion between the participants about the previous assignments. The study concluded that the women who engaged in writing therapy had significantly less anxiety than a comparison group who received only the standard pregnancy care. 17

Studies have shown that symptoms of depression decrease among people who utilize writing therapy. For example, in one study published in a 2014 issue of Cognitive Therapy and Research , one group of undergraduate students was tasked with non-emotional writing, or writing that does not focus on difficult or traumatic experiences and feelings, and another group was tasked with expressive writing, writing that does deal with emotional distress and trauma, focused in this case on emotional acceptance . The students in the latter group who experienced low or low to mild symptoms of depression saw a reduction in their symptoms. 18

Another study, conducted by researchers from the Catholic University of the Sacred Heart in Italy with women who had recently given birth, again divided participants into two groups; one performed expressive writing, and the other simply wrote about neutral topics. The women who used expressive writing had lessened depressive symptoms, whereas those in the neutral writing group saw no significant change. 19

Bereavement

People suffering the loss of a loved one can benefit greatly from writing therapy. It can reduce the number of negative feelings surrounding the event and allow for closure. It promotes self-care and therefore helps the client recover after a loss. 20 Writing therapy can also help reduce the separation anxiety that grief can prompt, gives clients a fresh perspective on their loss, and recognizes their bereavement journey. 21

A 2011 study published in the Journal of Psychosomatic Obstetrics and Gynaecology conducted 10 writing sessions over five weeks with people who had lost pregnancies. The participants were asked to write about their pregnancy loss, write a letter to a friend as if the friend were experiencing the same loss, and write a letter to themselves or to someone who witnessed the loss. The participants’ levels of grief and loss decreased after the writing therapy treatment. 22

Technology has made many forms of therapy more accessible for many people. The internet can connect people in nearly any geographical zone to therapists who may be physically distant. Writing therapy, in particular, transitions easily to the virtual world; most forms don’t require face-to-face meetings at all and can be conducted over email.

In addition, writing therapy is a form of self-help intervention that anyone may practice. Many writing prompts (such as these links from Disability Dame and Dancing through the Rain ) are available online and enable people to immediately begin writing and benefit from this therapy. 23 Whether practitioner- or self-guided, writing therapy is an accessible practice that offers many potential benefits to those who use it.

Moy, J. D. (2017). Reading and writing one’s way to wellness: The history of bibliotherapy and scriptotherapy. In Higler, S. (Ed.), New Directions in Literature and Medicine Studies (pp. 15–30). Palgrave Macmillan. https://doi.org/10.1057/978-1-137-51988-7_2
Holden, J. D., & Mugerwa, S. (2012). Writing therapy: A new tool for general practice? British Journal of General Practice, 62(605), 661–663. https://doi.org/10.3399/bjgp12X659457
THC Editorial Team. (May 22, 2021). Reading as therapy: Bibliotherapy and mental wellness. The Human Condition. https://thehumancondition.com/reading-as-therapy-bibliotherapy/
Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8(3), 162–166. https://doi.org/10.1111/j.1467-9280.1997.tb00403.x
Qian, J., Sun, S., Sun, X., Wu, M., Yu, X., & Zhou, X. (2020). Effects of expressive writing intervention for women’s PTSD, depression, anxiety, and stress related to pregnancy: A meta-analysis of randomized controlled trials. Psychiatry Research, 288. https://doi.org/10.1016/j.psychres.2020.112933
Lutgendorf, S. K., & Ullrich, P. M. (2002). Journaling about stressful events: Effects of cognitive processing and emotional expression. Annals of Behavioral Medicine, 24, 244–250. https://doi.org/10.1207/S15324796ABM2403_10
Normark, M., & Tholander, J. (2020). Crafting personal information: Resistance, imperfection, and self-creation in bullet journaling. Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems, 1–13. https://doi.org/10.1145/3313831.3376410
Goodrich, T., Hancock, E., Kitchens, S., & Ricks, L. (2014). My story: The use of narrative therapy in individual and group counseling. Journal of Creativity in Mental Health, 9, 99–110. https://doi.org/10.1080/15401383.2013.870947
Madigan, S. (2011). Narrative therapy. American Psychological Association.
McGihon, N. N. (1996). Writing as a therapeutic modality. Journal of Psychosocial Nursing & Mental Health Services, 34(6), 31–35. https://doi.org/10.3928/0279-3695-19960601-08
Ahessy, B. (2017). Song writing with clients who have dementia: A case study. The Arts in Psychotherapy, 55, 23–31. https://doi.org/10.1016/j.aip.2017.03.002
Kamphuis, J. H., Reijntjes, A., & van Emmerik, A. A. P. (2013). Writing therapy for posttraumatic stress: A meta-analysis. Psychotherapy and Psychosomatics, 82(2), 82–88.
Anderson, B. L., & Cyranowski, J. M. (1994). Women’s sexual self-schema. Journal of Personality and Social Psychology, 67(6), 1079–1100. https://doi.org/10.1037/0022-3514.67.6.1079
Lorenz, T. A., Meston, C. M., & Stephenson, K. R. (2013). Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: Results from a randomized clinical trial. The Journal of Sexual Medicine, 10(9), 2177–2189. https://doi.org/10.1111/jsm.12247
Barrett, M. D., & Wolfer, T. A. (2001). Reducing anxiety through a structured writing intervention: A single-system evaluation. The Journal of Contemporary Social Services, 82(4), 355–362. https://doi.org/10.1606/1044-3894.179
Shen, L., Yang, L., Zhang, J., & Zhang, M. (2018). Benefits of expressive writing in reducing test anxiety: A randomized controlled trial in Chinese samples. PLoS One, 13(2), Article e0191779. https://doi.org/10.1371/journal.pone.0191779
Esmaeilpour, K., Golizadeh, S., Mirghafourvand, M., Mohammad-Alizadeh-Charandabi, S., & Montazeri, M. (2020). The effect of writing therapy on anxiety in pregnant women: A randomized controlled trial. Iranian Journal of Psychiatry and Behavioral Sciences, 14(2). https://doi.org/10.5812/ijpbs.98256
Baum, E. S., & Rude, S. S. (2013). Acceptance-enhanced expressive writing prevents symptoms in participants with low initial depression. Cognitive Therapy and Research, 37. 35-42. https://doi.org/10.1007/s10608-012-9435-x
Camisasca, E., Caravita, S. C. S., Di Blasio, P., Ionio, C., Milani, L., & Valtolina, G. G. (2015). The effects of expressive writing on postpartum depression and posttraumatic stress symptoms. Psychological Reports, 117(3), 856–882. https://doi.org/10.2466/02.13.PR0.117c29z3
Kristjanson, L. J., Loh, R., Nikoletti, S., O’Connor, M., & Willcock, B. (2004). Writing therapy for the bereaved: Evaluation of an intervention. Journal of Palliative Medicine, 6(2), 195–204. https://doi.org/10.1089/109662103764978443
Thatcher, C. (2021). Whys and what ifs: Writing and anxiety reduction in individuals bereaved by addiction. Journal of Creativity in Mental Health. https://doi.org/ 10.1080/15401383.2021.1924097
Kersting, A., Kroker, K., Schlicht, S., & Wagner, B. (2011). Internet-based treatment after pregnancy loss: concept and case study. Journal of Psychosomatic Obstetrics and Gynaecology, 32(2), 72–78. http://doi.org/10.3109/0167482X.2011.553974
Wright, J. (2002). Online counselling: Learning from writing therapy. British Journal of Guidance & Counselling, 30(3), 285–298. https://doi.org/10.1080/030698802100002326

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On the Uncertain Border Between Writing and Therapy

Veronica esposito explores the intersection of creativity and trauma.

Years ago, I entered the world of mental health by getting myself a therapist. Little did I know that this small but decisive step would lead me deeper and deeper into the world of mental health, until I eventually found myself practicing therapy.

Every now and then I take a moment to look back on things, and I’m always kind of amazed: the changes the mental health world has made on me have been so great that it’s hard to imagine how the person I am today can actually occupy the same timeline as that of my pre-therapy self.

On a micro level, therapy has changed the very texture of the language that I use to speak and think my way through life; and on a macro level, it has transformed the basics of how I conceptualize myself and my world. To put it into literary terms, it’s a little like I switched the genre of my life—from say the claustrophobic modernism of a Franz Kafka to the truth-seeking comedy of a Lorrie Moore.

Going from Franz Kafka to Lorrie Moore is a pretty stunning change, and I think it shows the depth of what therapy can achieve. At its deepest, therapy seeks to make foundational change in who a person is. The various philosophies, approaches, techniques, laws, and ethics that collectively form the knowledge that therapy means to offer to the world is, at root, an attempt to imagine nothing less than how to live a good life and be a good person.

I’ve often reflected that such a transformative experience as that which I’ve had in the world of mental health must have made a sizable impact on who I am as a writer—and, in fact, many people have told me that they have seen the difference. I absolutely believe it’s there. Not just in how my writing looks and feels but in the very basis of what animates me to write, and basic assumptions I bring to my writing practice, how I envision and pursue the whole venture. My experiences have filled me with an interest in knowing exactly what therapy does for a writer’s work, which is why I set out to create this essay.

In researching this piece, I found something interesting: many creative writers and scientific researchers have explored the question of how creative writing may or may not be therapy, but I could not find anyone who had posed the question in the other direction: what impact therapy may have on one’s creative writing.

The research that I found on the matter tended—as research does—to focus on what effects specific applications of creative writing had on various mental health outcomes, like depression, dysfunction, and quality of life. There was an emphasis on trauma-processing and exploration, and the verdict was clear: writing can be an effective therapeutic tool.

By contrast, many of the creative writers who I read on the matter were much more leery of the prospect of writing being therapy. This is epitomized by memorist T Kira Madden’s Literary Hub essay “Against Catharsis: Writing is Not Therapy,” the jist of which states that artistic writing is much too prosaic and difficult to involve the “bleeding into the typewriter” that she equates with true “healing.” That is, when you’re laboring over every last word, there’s no room for catharsis—the very craftiness of creative labor precludes it, with Madden styling her writing self as just an actor working to create a product for an audience.

There were other voices, like that of Tara DaPra in Creative Nonfiction , who saw the writing process as more emotionally engaged and thus more therapeutic. In her essay “Writing Memoir and Writing for Therapy” she argues that “writing emotionally driven memoir is, in fact, cathartic, at least initially.” She see hammering out that messy first draft as akin to what one does in a therapy room, and she offers that this drafting can have further therapeutic benefits: you can let that draft sit for a while and return to your problems with fresh eyes, or the braver can show it to their friends and ask for input. In contrast to Madden’s boring workmanship, DaPra sees the writing process as driven by “emotion and instinct.”

Whether or not a writer was pro or con regarding creative writing being therapeutic, they tended toward an overly simplistic equation of therapy with the raw emotionality of catharsis. Certainly, therapy can provide individuals with space to fall to pieces and gush in a way that most daren’t do with friends, family, or partners, but it is much more than that. On its deepest and most powerful level, therapy attempts to change the basic assumptions and beliefs that one operates with as a human being: the story you tell yourself about who you are and what kind of a world you live in.

This is the most powerful kind of trauma-processing: to ask your brain to let go of the lessons that trauma has taught you and to instead believe in something different. Not all clients, of course, will reach that stage—for many, therapy may just be a space for emotional catharsis, working out day-to-day questions, and attaining better coping mechanisms—and that of course is fine and can still offer substantial benefit.

But I do think that, for writers, the opportunity to drill down to the most deeply held beliefs about who we are and what world we live in offers an amazing chance to examine the very stuff of one’s writing and to transform a writing practice. It is authors who had precisely these sorts of experiences in therapy whom I turn toward now.

Writer Isle McElroy, author of The Atmospherians , initially struck a note similar to Madden and DaPra, beginning our conversation by telling me that therapy has let them better “engage with traumatic events because I can see them differently because of the processing that I’ve done. It’s a thing that I can carry, not a thing that I have stepped inside of.” In our conversation, McElroy noted that they had to get through stages of processing their trauma; in these initial stages their writing tended to come out more like a journal-y first draft than a polished essay—therapy helped them do that work and move on to a different sort of writing.

Accordingly, McElroy explained that subsequent experiences in therapy went beyond just finding it useful as a tool for catharsis. They told me that therapy has helped them “connect with my curiosity. I’m being asked to have curiosity about myself that I didn’t previously. It’s the curiosity of discovery. Once I’ve become more settled, having an opportunity to explore has been really good. It drives me deeper into my own understanding of myself.” They added that “the relationship puts the onus on me, which has been especially helpful for the writing process. I’m digging deeper toward my actual thoughts.”

Ultimately, therapy lead McElroy to re-conceptualize the very purpose and goal of their writing: “a lot of the therapeutic process was finding self-worth outside of the entertainment that I can give to people. Previously my writing had been a desire to entertain others by revealing my own personal pain.”

McElroy’s remarks resemble my own experience of therapy and my aims as a therapist. Whereas the initial stages of therapy often involve lots of catharsis—letting go of all this painful emotional stuff that you’ve been holding on to—it usually moves on to a less emotionally flooded opportunity to re-envision yourself.

I very much relate to that deeper understanding of self that McElroy mentioned; for me personally, in drilling past the layers of trauma, I was able to see how so much of my relationship with the world was a product of that trauma mindset. I got down to a deeper stratum of self that felt more authentically me, and that I more and more let loose on the page. I also discovered, as McElroy mentioned, ways to be curious about myself, to in fact adopt curiosity as a stance.

I found my conversation with poet Kim Koga very stimulating in that she opened new ways for me to understand therapy itself as a creative process. Koga shared her experiences with EMDR—an acronym that stands for eye movement desensitization and reprocessing, an increasingly popular method for processing heavy trauma—telling me that EMDR felt like a creative process for her. “I like EMDR because it’s very experiential and creative,” she told me. “I use a lot of my creativity in my healing.” I liked Koga’s remarks because they troubled Madden’s binary of catharsis versus creativity: for Koga, catharsis itself involved using her creativity.

Koga was kind enough to share some of her experiences with EMDR with me, discussing it in terms very different from what many would consider therapy: she told me about magnificent, dreamlike journeys through her mind’s eye that she undertakes in the trance-like state created by EMDR. Part of Koga’s purpose in taking these inner journeys is to “make safe spaces inside my body and brain, where me and my child self can go. I put a door on it, where I can go when I need to.”

That is, when Koga has used therapy to build safe refuges where she can ride out the storm when she feels the trauma of past experiences manifesting in her brain and body. This process involves creativity that Koga has found transferable to her work as a poet.

In our conversation Koga also spoke of therapy in the more familiar terms of helping her get past creative blocks. “There’s a part of me that feels like I can’t stop writing the same poem that I’ve been writing since I was 20. I feel like so much of my poetry has been around trauma, death sex, violence. Therapy really helped me get unstuck. It’s helped me become more aware of things that I’m feeling, to move out of trauma in a way that can open my brain up more creatively.”

Koga also talked about therapy in terms of opening up her sensitivity: she shared how, before therapy, she used to be able to watch the extremely violent drama The Wire and not feel anything, but now she is so emotionally attuned that she finds it difficult to get through an episode.

Much of what Koga shared with me resonated with my own journey through therapy. Like Koga, it helped me to realign my sense of purpose and values so that I became interested in writing about different things than the trauma that had formerly drawn my writerly attention with a laser-focus.

Also like Koga, I found my senses opening back up, letting me connect with the world more thoroughly—this reconnection has had profound impacts on how I write. And even though I have not, like Koga, undertaken surreal journeys via EMDR, I have found that a lot of the creativity I’m pushed to use in therapy has also found applications in my writing process.

In writing this essay, I’ve come to see what a big, big topic this is, and I want to conclude here by stating my belief that this is a much larger story than I can hope to tell right here. Any sort of conclusion I can make right now is going to feel a little like a Band Aid. But, hoping to find somewhere to land for the time being, I’ll say the following: as writers, our inspiration and trauma often go hand in hand—they can often be difficult to distinguish, and they can feed off one another.

At this moment it feels right to hypothesize that my experiences in the world of mental health have left me better able to understand the inter-relationships between the two and to be in greater control of both. I’ll give the final word to Koga, whom I believe well embodies what I’m trying to say:

Post-therapy, the texture of my poems is now lighter and more introspective in an exploratory way, rather than focusing on the brutality that I felt. The textures have gotten more varied. It’s like when I walk into a fabric store and I can see everything, whereas I used to walk into a fabric store and feel like the black crepe was all there was. I feel like my poems are more nuanced than they used to be, and I’m more able to explore that darkness in a nuanced way.

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Veronica Esposito

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IAJW » IAJW Journal Blog » Journaling for Health & Wellness » What is Writing Therapy?

What is Writing Therapy?

What do you do?

Recently, I was sitting beside someone on an airplane (I travel a lot to facilitate workshops, speak at events, etc.) and she asked me, “what do you do?” I responded, “I am a Writing for Wellness Coach and I teach people how to use writing to improve their health, prevent burnout, and feel more joy in their lives through creative self-expression.”

This embarked us into a conversation about how her daughter has used journaling to help her get through a really dark time in her life. She said, “I have no idea how writing has helped her, but I can see that it has.”

I explained a bit about how expressive writing can be helpful in our lives and she was surprised to learn that there is something called “therapeutic journaling” and “writing therapy”. This field of work is not widely known (I am always explaining to people what it is I actually do!)

I told her about the IAJW.org and how we are a learning and inspiration community for journal writers worldwide and for people who want to experience the many life and health enhancing benefits of writing in their lives.

What is writing therapy?

Writing therapy involves using the written word, self-expression, and life story for the purposes of healing and self-discovery.

There are many ways to engage in healing and personal growth through contemplative practices such as meditation, yoga, mindfulness and in this case, expressive writing.

There is well over 35 years of scientific research that proves there are many benefits that can be gained through writing about your thoughts and feelings. Lowered blood pressure, improved immune functioning, reduced stress, greater confidence, more clarity for decision making, healing emotional wounds, improving personal relationships, cultivating personal resilience and making meaning out of life events are among the many proven benefits of expressive writing.

Learn more about writing therapy and the history of this healing and wellness practice https://en.wikipedia.org/wiki/Writing_therapy

Life Enriching Benefits of Creative Self-Expression

Beyond writing therapy, are the many life enriching benefits of creative self-expression. Journaling is a way to cultivate joy, gratitude and self-awareness in daily life. What we focus on grows.

Pause & Reflect

Do you write for wellness and personal growth? What has your experience been with this healing and expressive art? What area of your life or health would you like to improve? Journaling can help!

Access our free Journal Writing Gift which offers you ideas, information and inspiration for going to the page to write!

That’s really neat that writing therapy is an established form of therapy. I have found that when I’m having a difficult time, writing usually helps me clear my head and organize my ideas. I’m sure that this would be a very effective form of therapy for most people.

Please note, an earlier version of this article appeared on my prior CreativeWellnessWorks.com blog which is now integrating into the IAJW.org blog. Here’s to the healing and transformational power of writing!

The Role of Creative Writing in Therapy

I decided at the start of the year to practice what I preach in my role as a counsellor – to explore creativity as an enhancement to wellbeing – and joined a local creative writing group. There I penned my first piece of creative writing since leaving school. Our homework assignment from the group was for us to choose a memory from our childhood and write 2500 words.

I chose a memory at 11 years old, of my best friend choosing to go out with a girl one Saturday afternoon instead of playing with me. And in the writing of it, I found myself exploring themes of trust, the loss of innocence, betrayal and how when you’re 11 years old everything can quickly return to normal and life carry on. I realised when I read this out to the group the following week that what I’d ended up writing was not just a recollection, but more of a dissection of the things I was unable to voice at the time. This turned an autobiographical piece into a powerful drama that could give airtime and perspective at last to my feelings. Its rawness and vulnerability resonated deeply with the group, and from that beginning, I have gone right back to my adoption and written so far 50,000 words on the theme, ‘Days, events and people that have shaped my life.’ I’ve written quite forensically and as accurately as I can recall, helped particularly as far as my childhood was concerned by a wealth of family photos taken by my father, a talented photographer.

How often do we take the opportunity that’s there for all of us to dwell on the significant times in our lives? Even those of us who have had extensive therapy – and I’ve had 100 hours – didn’t spend that much time on this, and certainly not this amount of words. I have acquired a new thread of insight now that runs through my life. It’s been possible for me to understand now why I changed from innocent to worldly, or idealistic to materialistic, or from atheism to searching for a spirituality that fits me. Not from a developmental theoretical framework that I have learnt about, but from a highly specific personal journey.

I’ve had insight into the triggers that those significant ‘days, events and people’ have had on my own development, and why out of all the possible ‘days, events and people’ only thirty or so over the course of my life have been sufficiently significant to influence it. Why them and not others? Why is my memory so clear in sometimes forensic detail about those days, and yet most have flown by with little or no recollection? Why did my life turn on single moments, and then no significant change for relatively long periods of time?

I’ve made some obvious choices in marriage, divorce, births and parental deaths. But I’ve also selected other events that might not have affected anyone else’s life in anything in the way they have influenced mine – my walk to school, a general election, first real young love, first festival, a particular house I lived in as a student, my first afternoon at work …

I’ve also resolved not to offer my writing to anyone else other than possibly my immediate family, in order to not be swayed into making my life seem more glamorous, less shameful, and more virtuous than it really was. Indeed if no-one ever read it, it would have been a hugely worthwhile achievement in itself, and I think that’s what sets it apart from any ambitions to be an erstwhile published author. In not setting out to be published it’s freed me to write as honestly as I can recall, and to also introduce my own self-awareness now into events in the past. Neither have I sought to have my particular memories validated by for instance my sister, since I know our experiences of growing up were very different despite the efforts by our parents to raise us as equally as they felt able.

But perhaps the most significant and entirely unexpected outcome has been that I now have a desire to write a novel, something I’ve fantasised about for years but felt completely inadequate to know where to even begin. And in doing so I’ve laid to rest a comment made on the last piece of creative writing I produced by a teacher when I was 13. His words, ‘you’ll never make a writer’ now raise a smile of (slightly vengeful) glee when I recall them.

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May 18, 2022

Art Therapy: Creative Writing Exercises for a Healthy Mind

Updated: Aug 3, 2023

By Lynn Cukaj, ATR-BC, MHC-LP www.CreativeExpressionsConsulting.com

Art Therapy for Children, Teenagers and Adults

Writing offers...

a time to reflect

an increased awareness and insight

a place to let go

a chance to explore ideas

the process of experiences and situations

the practice of positive habit building

the ability to manage difficult emotions and thoughts

Do you want to unlock your creative voice and energy?

It is a way of communicating with yourself

It can serve to mend and heal

It can be insightful, passionate, and revealing

It is not only for creative types

It does not take a long time

It is not keeping a daily diary

It does not have to be shared with others

Creative writing is a healthy way to process feelings and thoughts. Creative writing is not about the product or being grammatically correct, but about the process of engaging in the activity and our creative expression. By engaging in creative writing exercises, we can gain a new perspective into our thoughts and feelings. This process is part of the healing journey to gain a better sense of self and connection to the world around us. A large part of a healthy lifestyle is having a variety of ways to cope with stress and anxiety. Creative writing is one type of coping skill that is worth exploring in depth. The following activities are examples of creative writing that are especially beneficial for healing and growth.

Mindfulness is a frame of mind; being keenly aware of the moment while acknowledging and accepting our thoughts and actions with a non-judgmental attitude. Engaging in daily mindful activities encourages us to be in the present moment, taking a much-needed break from being anxious about the future or sad about the past. Being mindful and staying in the present moment is the foundation of creative writing to promote wellbeing.

Journaling is a harmonious blend of mindfulness and creative writing, granting yourself a space for uninhibited self-expression without judgment. Journaling becomes a valuable companion through life's challenges, as it encourages us to process our daily experiences, offering profound benefits during tough times. Allow the act of reflection to become a stress-relieving and emotionally liberating journey as you choose from the prompt examples below, finishing the sentences and delving into your thoughts on paper for as long as you desire. Embrace the freedom to unleash your creativity, even through art, as you embark on a transformative journaling adventure.

Journal Prompts:

Five things I am grateful for today...

The best book I've ever read and why I loved it...

A place I've always wanted to visit and why...

If my body could talk it would say...

What are 10 words I would use to describe myself?

My favorite way to spend a rainy day is...

Three things I would like to change about myself...

The most memorable dream I've had recently...

A new skill or hobby I want to learn and why...

The top five people who have influenced my life...

My perfect day from morning to night...

A challenge I overcame and how it changed me...

The best piece of advice I've ever received...

My favorite childhood memory and why it's special...

A time when I felt truly proud of myself...

The top three qualities I value in a friend...

A playlist of songs that represent my life right now...

My ideal way to practice self-care and relaxation...

A significant lesson I've learned from a past mistake...

If I could travel back in time, I would go to...

Five things I want to achieve in the next five years...

Positive affirmations can be another creative way to express yourself and open your mind to new discoveries. Expressing a positive affirmation is a powerful way to focus on the good that we want to see in ourselves and in this world. It replaces deconstructive negative thoughts with proactive self-talk. On a sheet of paper, make a list of positive affirmations such the ones listed in this Positive Affirmation blog .

A Gratitude List is a creative writing activity that is most effective when done first thing in the morning or before going to bed at night. The process helps us shape our mindset to appreciate the people, places, and experiences around us. In a journal, write 5 things that we are grateful for, big or small. Take a deeper dive into ways to practice gratitude for a better life .

Writing Prompts: Writing is an instrumental tool we can all use to manage stress. Writing prompts are a great way to get started if you don’t know where to begin.

Choose one or many of the writing prompts below to finish the sentence.

This week I observed…

I got upset when…

I feel hopeful about…

When I think about my day, I …

Each day brings…

Today/tomorrow/this week, my goal is to…

When things are challenging, I want to remember…

“I am so _____________________”

Quote Piggy-Backs is when we choose a quote that resonates with us and apply it to our own lives. Many times we come across inspirational quotes but this creative writing exercise allows us to go beyond simply reading it, but rather, connecting with it. Examples:

Worrying does not take away tomorrow’s troubles; it takes away today’s peace .

- Randy Armstrong

Write down your worries. At the end of each worry, write the following: “I accept this feeling and I let it go.”

Talk to yourself like you would to someone you love. - Brené Brown

Use this quote to finish the following statements:

I am lovable because….

I show my love to others by….

Permission List is a creative writing activity to embrace self-compassion. In order to let go, we must give ourselves permission to have faults, weaknesses, and imperfections. Having the need for things to be perfect is stressful, and this writing technique allows us to address some of these unrealistic expectations . Choose from the list of writing prompts below to begin the process of accepting yourself for who you are and supporting your journey to achieve inner peace.

I give myself permission to…

Make a mistake doing…

Take a break from...

Ask for help with…

Say no to...

Take a risk to…

Try something new like…

Feel my feeling of…

Trust the process of…

Give myself...

Reframing frustrations is a way to separate yourself from the challenges you are facing to give yourself a chance to breathe and see the issue from a different perspective. Write or draw any of your anxieties or frustrations on a page, being as elaborate as you wish. Then take your page and tear it up. Take the pieces and create a piece of collage art in the art journal. Writing, tearing, and creating show how we feel, express, and work things out.

As you explore the different ways of incorporating creativity into your life such as creative writing, you will discover new ways of creative expression. Creative expression is a way to provide a voice for some of life’s difficulties that are too painful to talk about. By writing, we offer ourselves ways to express ourselves in a positive, productive, and healthy manner.

There is a misconception that people need to be skilled in the arts to be creative. Writing is a great way to break through this falsity and opens up the opportunity for us to engage in art-related activities. All humans are creative, and we each have our own unique way of expressing it.

For more therapeutic activities and resources on how to incorporate Art Therapy into your life, read more from Lynn's Creative Expressions Blog .

Learn more about Art Therapy and Lynn Cukaj, Board Certified Art Therapist here: www.CreativeExpressionsConsulting.com

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What Creative Arts Therapies Teach Us About DBT Skills Training

Bridging dbt with the arts for deeper understanding..

Posted April 15, 2024 | Reviewed by Jessica Schrader

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Research supports the effectiveness of combining DBT with creative arts to improve outcomes.
Facilitators can teach wise-mind skills through drama therapy techniques.
Action-based DBT utilizes storytelling and role-play to make skill learning more accessible and impactful.

In the ever-evolving realm of mental health, therapists are always exploring new and innovative methods to enhance traditional treatments. Creative arts therapists have led the way in utilizing art-based interventions to teach DBT skills.

Creative arts therapy combines visual arts, movement, drama, music, writing, and other creative processes to support clients in their healing process. Many mental health clinicians have embraced creative arts therapy interventions to improve their clients' health and wellness.

There is a growing body of research that indicates that therapists can utilize creative interventions to help clients learn and generalize DBT skills. In this post, I will provide a brief literature review of therapists who have been doing this integrative work and provide an example of how drama therapy can be utilized to teach the DBT skill of wise mind.

DBT and Art Therapy

Research indicates that integrating art therapy into established psychotherapy forms, such as cognitive-behavioral therapies, can have significant positive effects on client well-being. For example, a study by Monti et al. (2012) demonstrated the potential of mindfulness -based art therapy (MBAT) in alleviating emotional distress, highlighting the power of combining art therapy with the core feature of mindfulness in DBT. Though this study did not specifically discuss DBT, it demonstrated that implementing mindfulness, a core component of DBT, can assist individuals who are facing significant physical and emotional stressors.

Building on research that examined mindfulness and art therapy, several practitioners have contributed articles that specifically address the integration of DBT and art therapy within clinical populations. For example, researchers Huckvale and Learmonth (2009) led the charge by developing a new and innovative art therapy approach grounded in DBT for patients facing mental health challenges. Furthermore, Heckwolf, Bergland, and Mouratidis (2014) demonstrated how visual art and integrative treatments could help clients access DBT, resulting in stronger generalization and implementation of these skills outside of the session. The clinicians concluded that this integrative approach to treatment could reinforce skills, contribute to interdisciplinary team synergy, and enact bilateral integration.

Other notable examples from art therapists include Susan Clark’s (2017) DBT-informed art therapy, a strategic approach to treatment that incorporates creative visual exercises to explore, practice, and generalize DBT concepts and skills.

Expanding Beyond Visual Art Therapy

DBT has now been integrated with other expressive art therapies, including drama and music. Art therapists Karin von Daler and Lori Schwanbeck (2014) were instrumental in this expansion when they developed Creative Mindfulness, an approach to therapy integrating various expressive arts therapies with DBT. Creative Mindfulness “suggests a way of working therapeutically that is as containing and structured as DBT and as creative, embodied, and multi-sensory as expressive arts” (p. 235). These clinicians incorporated improvisation into their work, a tool that can be simultaneously playful, experiential, and grounding, ultimately producing substantial new insights for clients.

Moreover, music and drama therapists have recognized the benefits of multisensory skill teaching, expanding the creative techniques used to teach DBT skills ( Deborah Spiegel, 2020 ; Nicky Morris, 2018 , and Roohan and Trottier, 2021 ).

My Own Experience Integrating Drama Therapy and DBT

Personally, I am a big advocate of both dialectical behavior therapy (DBT) and drama therapy. In fact, I love these modalities so much that I dedicated not only my master's thesis but also my dissertation to better understanding how to reinforce DBT skills through dramatic techniques. In the process, I developed a new approach called Action-Based DBT that uses dramatic interventions like storytelling, embodiment, and role-playing to create a supportive environment for participants to learn skills in a more personalized and embodied way. An expert panel review demonstrated that this format can effectively support skill learning, especially for clients who struggle with the standard format of DBT skills training. Additionally, mental health clinicians found the program easily adaptable across populations in both individual and group settings.

Embodying the Mind States

To illustrate this approach and its effectiveness, the following is an example of how drama therapy methods can teach the DBT skill of wise mind within the context of an action-based DBT group.

The facilitator begins the group session by reviewing general guidelines and introducing the targeted DBT skill for the day: wise mind. The group then participates in improvisational warm-up activities to promote creativity , positive social interaction, and group connectivity. Following the warm-up, the facilitator distributes the DBT mind states handout (Linehan, 2015) and provides brief psychoeducation on this skill. Three chairs are placed in the front of the group room, facing the semi-circle of clients. Each chair had a piece of colored construction paper taped to the front, reading as Reasonable, Wise and Emotion . The facilitator explains that each chair represents one of the three mind states: reasonable mind, emotion mind and wise mind. To encourage exploration of the mind states, the facilitator can assign a more specific role to each state of mind. For example, the reasonable mind is The Computer, the emotion mind is The Tornado, and the wise mind is The Sage. Group members are invited to think of a scenario in which they felt they had difficulty accessing their wise mind. Clients then take turns embodying each mind state by sitting in the chair and speaking from the respective role. When a client first sits in a chair, the facilitator aids in enrolling the individual by asking questions about the role (i.e. The Computer, The Tornado, The Sage). For example, the facilitator may ask about the posture, tone of voice, or a “catchphrase” for this role. The client then embodies the role and responds to questions from the group as the specific mind state. After the embodiment, clients engage in verbal processing. The wise mind directive supports clients in developing kinaesthetic awareness of the three mind states. Embodying these mind states within the context of a supportive group and engaging in verbal processing around the experience can increase awareness of the mind states, which is helpful for clients who are trying to understand their emotional response to lived events outside of the group setting.

The creative arts therapies offer a dynamic pathway to teaching and reinforcing DBT skills. Incorporating visual art, drama, or music in the process of learning DBT skills allows clients to engage with these concepts in a multisensory and embodied way.

In my personal experience, weaving drama therapy techniques into DBT skills training has proven to be profoundly impactful. The Action-Based DBT approach, with its emphasis on storytelling and embodiment, offers an immersive and experiential learning environment that can be especially beneficial for those who find traditional methods challenging.

Looking ahead, my next post will delve into how storytelling can be harnessed to teach DBT skills in a way that is both engaging and memorable.

To find a therapist, please visit the Psychology Today Therapy Directory .

Clark, S. M. (2017). DBT-informed art therapy: Mindfulness, cognitive behavior therapy, and the creative process. Jessica Kingsley Publishers.

Heckwolf, J. I., Bergland, M. C., & Mouratidis, M. (2014). Coordinating principles of art therapy and DBT. The Arts in Psychotherapy, 41(4), 329-335.

Huckvale, K., & Learmonth, M. (2009). A case example of art therapy in relation to dialectical behaviour therapy. International Journal of Art Therapy, 14(2), 52-63.

Monti, D. A., Kash, K. M., Kunkel, E. J., Brainard, G., Wintering, N., Moss, A. S., Rao, H., Zhu, S., & Newberg, A. B. (2012). Changes in cerebral blood flow and anxiety associated with an 8-week mindfulness programme in women with breast cancer. Stress and Health, 28(5), 397-407.

Morris, N. (2018). Dramatherapy for borderline personality disorder: Empowering and nurturing people through creativity. Routledge.

Roohan Mary Kate, Trottier Dana George. (2021) Action-based DBT: Integrating drama therapy to access wise mind. Drama Therapy Review, 7 (2), 193 https://doi.org/10.1386/dtr_00073_1

Spiegel, D., Makary, S., & Bonavitacola, L. (2020). Creative DBT activities using music: Interventions for enhancing engagement and effectiveness in therapy. Jessica Kingsley Publishers.

Von Daler, K., and Schwanbeck, L. (2014). Creative mindfulness: Dialectical behavior therapy and expressive arts therapy. In L. Rappaport (Ed.), Mindfulness and the arts therapies: Theory and practice (pp. 107-116). Jessica Kingsley Publishers.

Mary Kate Roohan, Psy.D., is a licensed psychologist and drama therapist and the founder of Thrive and Feel, a therapy practice that supports clients in managing emotional sensitivity.

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At any moment, someone’s aggravating behavior or our own bad luck can set us off on an emotional spiral that threatens to derail our entire day. Here’s how we can face our triggers with less reactivity so that we can get on with our lives.

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Writing Memoir and Writing for Therapy

An inquiry on the functions of reflection.

A year and a half into my undergraduate studies, my boyfriend Matthew committed suicide, which threw a wrench into the straight line I’d envisioned my college life would follow. I transferred schools before dropping out and then floated around for a while. His was the first death I’d experienced, and it changed me irrevocably. Amid my grief, I puzzled over how removed Americans are from death and loss.

Eventually I resumed my studies, at the University of Minnesota, and enrolled in “Cinematics of Loss,” a film class offered by the English department. The professor had recently written a book about how she’d never properly grieved her father’s death—he had drowned when she was nine—until as an adult, she found herself sobbing at every film she attended. We watched Krzysztof Kieslowski’s Blue , Peter Weir’s Fearless , and Hirokazu Kore-eda’s Maborosi . I wrote a paper analyzing the ways in which Todd Field’s beautiful film In the Bedroom , based on Andre Dubus’s short story “Killings,” captures the differences between masculine and feminine grief.

One day, I approached the professor and said something clumsy like, “This is what I want to do with my life.” I didn’t know quite what this was, but I knew I wanted to be engaged with the human questions of loss and grief, to acknowledge them as an essential part of being. I wanted to write and think and talk about them. I thought, first, about psychotherapy and then, briefly, considered becoming a funeral director. (With the Baby Boomers rounding that metaphorical bend, there’d be no shortage of work.) “Have you considered creative nonfiction?” my professor asked. I had never heard of creative nonfiction as a literary form, though like many, I’d certainly read it and even written a bit.

On the first day of “Introduction to Literary Nonfiction,” the instructor, a graduate student, introduced herself and made an announcement: “This class is not therapy.” Afterward, I went to her office hours in a panic. “But I find writing very therapeutic,” I said. “Am I doing something wrong?”

She backtracked. “I do, too,” she said. “It’s just that last semester, I had students turning in diary entries about what jerks their boyfriends were.”

In making her announcement, my instructor was wrestling to separate reflection, that fundamental element of creative nonfiction, from the task of general psychological introspection. But I wondered: Is there a difference?

In her classic essay “Memory and Imagination,” Patricia Hampl writes:

Our capacity to move forward as developing beings rests on a healthy relationship with the past. Psychotherapy, that widespread method for promoting mental health, relies heavily on memory and on the ability to retrieve and organize images and events from the personal past. . . . If we learn not only to tell our stories but to listen to what our stories tell us—to write the first draft and then return for the second draft—we are doing the work of memory.

Hampl describes how psychotherapy mimics the writing process, but I wondered whether the reverse was also true: Could writing about pain and loss do the work of psychotherapy? And if so, could this writing be “literary,” or did it become something else, something lesser?

While there are clear parallels between reflecting in creative nonfiction and reflecting in our private lives, academia—like the larger culture—remains anxious about crossing into the land of therapy. Do writing teachers fear tissues littered across the floor, strangers breaking down? Or are we afraid of opening our own wounds? We’re trained to compartmentalize relationships and responsibilities, to be professionals. Writing is about writing. Want to be safe? Stick to nature, or call it fiction.

At other times, writing teachers struggle to draw the line between instruction and counseling. In another creative writing class I took, a classmate wrote about the death of her friend’s son, and the professor responded by recommending she read books about grief. The student became frustrated that she was focusing on the subject matter instead of the writing. But in that same class, another student seemed to want more than a literary critique. He wrote about contemplating a jump from the bridge connecting the east and west banks of our campus. He was fixated on John Berryman, the Pulitzer Prize-winning poet who’d taught at Minnesota and committed suicide off that very bridge, which led us to spend valuable workshop time talking around our concerns for his well-being.

These delicate moments do come up, and when they do, sensitive and caring individuals will look to offer comfort; triage requires that we first attend to bleeding wounds. Yet should these situations (which any writing teacher will attest are unavoidable) discourage writers from sharing emotionally charged and personal material? And how can writing teachers acknowledge the complicated relationship between writing and real life without asking students to sanitize the works they present to class?

This tension bears out in Ann Patchett’s afterword to Lucy Grealy’s memoir Autobiography of a Face , which chronicles Grealy’s story of disfiguring jaw cancer. Patchett, who attended the Iowa Writers’ Workshop with Grealy, describes one of Grealy’s readings:

As the crowd in Rizzoli’s wept over the passage she read about being tortured by schoolboys in stairwells, my brave and heroic Lucy made it clear to the audience that she had no interest in being anybody’s inspiration. She was not there as a role model for overcoming obstacles. She was a serious writer, and she wanted her book to be judged for its literary merit and not its heartbreaking content. When people raised their hand to ask a question, more often than not that question turned out to be a statement of what they themselves had endured. Lucy refused to let the evening divulge into a litany of battle stories. . . . [S]he made her point: she was making art, not documenting an event. That she chose to tell her own extraordinary story was of secondary importance. Her cancer and subsequent suffering had not made this book. She had made it. Her intellect and ability were in every sense larger than the disease.

Grealy’s bristling at her readers is typical of the academic response to the emotional content of a memoir: We must not acknowledge the relationship between the content and the writer, lest the writer look like a flawed person and not a literary genius. Yet Patchett commits this very act when she calls Grealy “my brave and heroic Lucy.” Lucy Grealy was a very talented writer, but she was also a girl and a woman who endured the emotional and physical pain of a devastating disease. While it’s true that “her cancer and subsequent suffering had not made this book,” it’s also true that without cancer, there’d have been no book. Most readers don’t pick up a memoir because they imagine it will be literary masterpiece; they’re looking first and foremost for a compelling story. It’s unrealistic of writers to expect readers of memoir—a genre that by its very definition reveals the consciousness of the writer—not to connect with them, just as it’s unrealistic of writing teachers to surgically excise the emotional lives of writers from the material being written.

In 1997, Kathryn Rhett compiled a collection entitled Survival Stories: Memoirs of Crisis , which the New York Times book critic Michiko Kakutani critiqued as “conflat[ing] literature and therapy.” Kakutani took the book’s publication as an opportunity to decry everything wrong with the genre of memoir: “The current memoir craze has fostered the belief that confession is therapeutic, that therapy is redemptive and that redemption equals art, and it has encouraged the delusion that candor, daring and shamelessness are substitutes for craft, that the exposed life is the same thing as an examined one.” I’ve read that sentence many times, looking to find the lapse in logic. I certainly don’t argue with the first two assumptions: 1) “that confession is therapeutic” and 2) “that therapy is redemptive.” At the very least, confession has the potential to be therapeutic, just as therapy can be redemptive. It’s what follows—“that redemption equals art”—that causes the problem.

Kakutani takes issue with this idea. I agree that confession and redemption alone are no formula for good writing or art of any description, but that doesn’t mean that they can’t co-occur. And doesn’t a life have to be exposed—at least in part—before the writer can examine it? Why can’t a memoir speak about trauma or reveal family secrets and still be literary?

In fact, countless books do this well. They typically begin with the writer’s emotional turmoil simply because it’s an easy way to introduce conflict. Losing the Garden: The Story of a Marriage by Laura Waterman begins with the author’s husband leaving their secluded home in the mountains of Vermont to commit suicide. He has planned it out—if suicide can ever be considered a rational decision, a question the book seeks to resolve—and she has allowed him to leave. This memoir explores an act that’s strange and unthinkable. Likewise, Kathryn Harrison, in The Kiss , writes about her adult incestuous relationship with her estranged father. Some readers were put off by what was deemed the taboo nature of her subject (indeed, this may have dominated the conversation about the book), but I’d argue that the desire to read about these very private moments in the lives of others is not simply voyeuristic. It isn’t simply gawking. It’s a human instinct to witness another’s pain, to attempt to understand it, and, ultimately, to learn from it. We want to better know the human experience, the human condition; readers and writers of memoir are both in pursuit of thoughtful reflection.

Other books explore a more prosaic but no less harrowing type of family conflict. In his essay “Shame and Forgetting in the Information Age,” Charles Baxter considers this: “It is natural that a writer would want to write about parents, but recent memoirs seem to have reserved a special place for missing or empty or vacated or just bad fathers. Something has gone wrong with fathers; there is something either shameful or absent about them.” He goes on to name several books I’ve read and loved: Paul Auster’s The Invention of Solitude , Harrison’s The Kiss , Mary Karr’s The Liars’ Club . To his list I would quickly add Rick Bragg’s All Over But the Shoutin’ , J. R. Moehringer’s The Tender Bar , and Frank McCourt’s Angela’s Ashes . Readers want these stories not because they wish to eavesdrop on another’s misfortune, but because fathers are imperfect, because the parent–child relationship is a complex and messy one, because the universal can be understood through the specific.

The repetitions of subject matter, as well as the commercial and literary successes of these titles, suggest that memoir reaches the reader’s psyche in an important way and also that such stories can be thoughtfully crafted. So my struggle with Kakutani’s critique and professors’ disclaimers is that they tell novice writers of creative nonfiction to stay far away from sensitive subject material, from anything that might make the classroom uncomfortably resemble a therapist’s office. It was this dissonance that, for a long time, kept me from understanding that it was okay to write creative nonfiction, to create art in the form of text, and, concurrently, to find therapeutic value in the work.

From my experience in an MFA program, the academy doesn’t like to talk about the fact that writing emotionally driven memoir is, in fact, cathartic, at least initially. That’s the drafting stage—getting it out of one’s head and on to the paper—and sometimes the draft comes out sounding like, “My boyfriend—boy, was he a jerk.” If the writer doesn’t know what to do with the material, if she can’t see anything bigger than “this happened,” there are three choices.

First, toss it. Perhaps it was just a vent. No harm, no foul.

But I favor the other options. One of them: put it away for a while. When you return to revisit the work, you can try to make some sense of the raw material. This requires a critical examination of what’s on the page; it requires making choices about what belongs in the narrative and what must be cut. As William Faulkner famously said, “Kill your darlings.” To revise raw material, to bring a piece of writing to a satisfying conclusion, requires a resolution. I have written on a subject that felt important, but wasn’t able to conclude the piece, perhaps because the story was not yet resolved in my own life. That’s okay. I’ve generated raw material that can wait patiently for me to return someday.

The final option is to show the draft to others to see if they can spot a narrative thread worth developing. But this option is tricky, because it requires the writer to expose herself to others, to present her as-yet-unresolved problem—I’m depressed/I hate my mother/my boyfriend left me and I feel sad—and to ask her fellow writers if there’s anything worth developing. This is where writing teachers get uncomfortable because workshops sometimes sound like group therapy sessions. To help create distance between what’s on the page and the living, breathing writer in the room, writing programs encourage the use of language like “the character” or “the narrator.” But it’s inevitable that a story thread must be exposed before it can be examined.

Research has confirmed that writing about emotionally charged memories is good for the health of the writer—and not just her psyche. In April 1999, the Journal of the American Medical Association published a study that linked writing about stressful life experiences to improved health. But as reported in the Chicago Tribune , Joshua M. Smyth, the study’s co-author, cautioned, “It actually has little to do with raw catharsis, which, I think, is what people assume.” Smyth explains that the health benefits were a result of cognitive restructuring—learning to think about problems in a new way—along with changing levels of stress and anxiety. So while the initial writing—the first draft—may provide a cathartic effect, the lasting benefit comes from seeing the problem in a new light—the organizing, editing, and structuring of a piece of writing.

But what of the cathartic effect? Should we be so quick to dismiss it? I imagine catharsis as an evolutionary adaptation, nature’s mechanism of positive reinforcement. Catharsis feels good, so writers seek to recreate the experience, in this case by continuing to write about troubling experiences. This initial purge can lead to mulling over, which results in new ways of seeing old problems and an evolution of thought.

Writers, no matter their genre, find inspiration to write from the same source: something they hear or see or otherwise experience stays with them. They can’t stop musing; they must investigate. Writing is just another form of problem solving. Like psychology or medicine, it’s a drive to understand the human condition experientially, one that’s led by emotion and instinct. The success of a piece of writing is proven by readers connecting with the writer’s words, knowing on some basic level that what the writer has composed touches on a truth of human experience. For this reason, I’ve always encouraged my students to write on sensitive topics but with the understanding that the purpose of our class is to examine the narrative and aesthetic merits of what’s on the page, including—and especially—whether the emotion rings true. Finding a subject is an important part of developing as a writer. And if the writer receives any psychological benefit from constructing the narrative—and she very well may—that’s wonderful. On the other hand, if the material is especially raw and difficult to process, the writing process may lead to clarity, but working with a therapist can also help the writer order the emotion. It should come as no surprise that this may also help the writing.

Of course, not all generating leads to thoughtful examination, and not all drafts can be crafted into finished products. The point is, that isn’t the fault of the subject. Poorly run group therapy, where members do nothing more than complain about the same problems over and over again, doesn’t make people better, either; in fact, it can make them much worse, by reinforcing negative thought patterns. But both writers of memoir and those in therapy must reflect thoughtfully on their stories . . . which leads me to recalculate my reasoning from the start of this essay. When my instructor declared that writing creative nonfiction is distinct from therapy, she wasn’t actually seeking to “separate reflection, that fundamental element of creative nonfiction, from the task of general psychological introspection.” Reflection, quite simply, is psychological introspection. One is written while the other is oral, but both good writing and good therapy require a narrative to be ordered and assembled. Patricia Hampl’s words confirm this: “If we learn not only to tell our stories but to listen to what our stories tell us—to write the first draft and then return for the second draft—we are doing the work of memory.” What my instructor really meant to say is that it’s important to revise.

I began writing creative nonfiction because I felt an urgency to share my stories. Writing also provided an escape from my grief and a small way to raise the dead. But as Annie Dillard warns in her essay “To Fashion a Text,” “You can’t put together a memoir without cannibalizing your own life for parts. The work battens on your memories. And it replaces them.” As happens often enough, science has caught up with art to confirm this notion. Neuroscientists now tell us that the simple act of recalling and restoring changes the brain’s organic structure. The natural condition, it seems, is for stories and memories to change over time.

Dillard’s words proved true in my case. The struggle to go on living when someone I loved could not see value in his own life, the pain and the anger and the deep, pooling sadness—all these emotions began to fade after I saw the ink on the page. The writing process brought those feelings from inside me out into the sunlight. It said, “This happened. Your pain is real.” Catharsis was my initial motivator, but that alone didn’t sustain me. Generating, which sometimes comes easily, other times painfully, is only the first step in the writing process. The real work is in workshop, revision, and polishing the completed work.

I’ve come to love wrestling out an argument and polishing rhythmical prose. Perhaps the only recompense for tragedy—for death and loss of innocence—is the chance to create some measure of beauty. The marvel of a well-crafted sentence—finding just the right diction and syntax—is a small triumph over pain, a way to create order in the world. That world, at times, may be nothing more than a writer and her pen. Writers find pleasure in moments of flow, a loss of consciousness, but as any practitioner of meditation will tell, this is simply preparation to engage in the world and to develop a more refined consciousness. After all, what is the human experience if not an attempt to order pain and chaos?

Ms. DaPra, Ms. DaPra,

This piece has helped me “get it” when it comes to writing my memoir. Thanks.

Thank you, Tara Dapra, from a writer’s whose bio states, “I write because it’s cheaper than therapy.”

Thankyou for these insights Tara. As one embarking on my memoirs I find them invaluable.

4 Free Creative Alternatives to Talk Therapy That Can Support Your Mental Well-Being

S eeking mental health support when you need it is important for looking after your overall well-being. A common misconception about mental health, however, is that speaking to a counselor or therapist is the only option.

Talk therapy isn’t the best-suited option for everyone. If you’ve tried and disliked speaking to a therapist, or if it’s just not your cup of tea, don’t fret. With a little digital help, you can access different therapy options to better suit your needs. Here are some creative alternatives to talk therapy that can support your mental well-being.

1. Journal Writing Prompt Therapy

Journal writing prompt therapy is exactly as it sounds—you use prompts for journaling that can support and improve your mental well-being. The idea behind journal writing prompt therapy is to answer questions to dig deep into your emotions, anxieties, fears, and experiences and help process difficult feelings, experiences, or memories.

Journal writing prompt therapy can help you overcome various barriers in your life. Its benefits include improved self-awareness and compassion, processing trauma and making sense of distressing situations, managing difficult emotions, and providing a safe space to explore your thoughts and experiences freely without judgment or punishment.

There are several digital tools you can use to get started with journaling writing prompts therapy, including:

Pinterest. Simply type “journaling writing prompts therapy” into the Pinterest search bar to receive endless therapeutic journaling ideas. Pin or save for later use.
Online resources. Websites such as Oprah Daily , PsychCentral , and Positive Psychology offer free journal prompt resources to help support your mental health.
YouTube. Channels created by licensed therapists, such as Therapy in a Nutshell , offer videos on journaling prompts for mental health.
CBT apps. Using a self-guided CBT (cognitive behavioral therapy) app such as Intellect: Create a Better You provides guided journal prompts and programs to help support your mental health. (Learn how to use the Intellect app to aid your mental health here.)

Download: Intellect: Create a Better You for Android | iOS (Subscription required, free trial available)

2. Expressive Arts Therapy Activities

If you find it difficult to articulate what you’re feeling, then expressive arts therapy is a multi-modal approach to mental health support that can be useful. Instead of talk therapy, you can use a variety of non-verbal art modes to help you access your emotions, express yourself, and heal.

Expressive arts therapy isn’t just limited to visual arts—it also includes crafting, dancing, writing poetry or lyrics, and playing or listening to music. The idea is to use whatever form of art you enjoy best to express yourself. You can allow your imagination and creativity to take over as you lean into an emotional process of self-discovery.

Here are a few ways you can try expressive arts therapy:

Poetry. Reading or writing poems can help you express deep-seated emotions and explore your feelings through the written form. The National Association for Poetry Therapy is a good place to start. You can also use the PoemHunter website (or mobile app) to read, analyze, and discuss poetry to help support your mental well-being.
Dancing. You can try therapeutic dancing for free in the privacy of your own home by playing a game like Just Dance Now . Udemy offers a course to learn dance therapy. Alternatively, use the American Dance Therapy Association to find a registered therapist for Dance/Movement Therapy (DMT).
Crafting. Crafts can be a therapeutic pastime, whether it's pottery, textiles, paper crafts, or scrapbooking. For crafting inspiration and tutorials, try the Creativebug app.

Expressive arts is about finding a creative outlet to process and express your feelings, experiences, and healing.

Download: Creativebug for Android | iOS (Free, in-app purchases available)

3. Music Therapy

Music Therapy is a clinical and evidence-based practice that uses music interventions (often facilitated by qualified music therapists) to achieve your personal mental health goals. These goals could be expressing feelings, managing stress, or alleviating pain through interventions such as music improvisation, receptive music listening, songwriting, or playing an instrument.

A common misconception about music therapy is that you need to have some sort of musical ability to benefit from the practice, but you don’t! There also isn’t one style of music that’s more beneficial than the other, so the key with music therapy is picking the instrument, style, or sound that you like the most, and seeing how it can help you.

To try music therapy yourself, here are a few accessible starting points:

Listen passively. Playing relaxing music in the background can help reduce stress and strengthen your well-being. There are plenty of free music streaming services you can try , from YouTube Music to the ever-popular Spotify .
Create music. You can either play an instrument or use a music generator to compose your own music and songs . If you don’t have any musical experience, you can learn to play an instrument online, using resources such as New Guitar Lessons , Drum Lessons , or Hoffman Academy .
Write your own lyrics. Therapeutic songwriting can help you address and process any emotional traumas or express your ideas and feelings. Online tools such as SongPad and LyricStudio can help you with your songwriting process.

If you’re keen to learn a new instrument, but not sure which one to pick, give Yousician a go. The app offers lessons on bass, guitar, piano, ukulele, and singing, taught through step-by-step video guides. As the content on Yousician is created by music teachers, it’s the next best thing to being taught in person. Yousician can also give you feedback on your progress by using the record function.

Download: Yousician for Android | iOS (Free, in-app purchases available)

4. Art Journal Therapy

Another creative activity that can boost your mental health is art journal therapy. For art journal therapy, you use a diary to visually express your thoughts, emotions, and ideas through your preferred art form. Think drawing, sketching, painting, photographing—you can approach an art journal for therapeutic uses based on your favorite type of art.

As with most journaling practices, the idea with visual journaling is to practice consistently. Picking a time of day to work in your journal can help promote its benefits, from mindfulness and self-expression to stress reduction.

You can try art journal therapy using MoodArt—an app designed to help you map your emotions and express them in an artistic way. It’s easy to get started with the free version: simply tap the plus ( + ) icon (located within the calendar and at the bottom of the screen) to start your expressive art therapy activity.

You can create your expressive art using the following features:

Factors tab. Tap the theater faces icon to open the Factors menu. Scroll across to find an illustration that represents what area of your life you wish to express or explore (e.g. family, finances, news, relationships, or work) and tap to add it to your picture.
Shapes tab. Tap the shapes icon to choose different shapes to add to your picture.
Background color tab. Tap the fill icon to pick a color for the background of your picture.

For each shape or illustration that you add to your picture, you can modify its shape, size, orientation, and color. Keep adding and editing elements to your picture until you feel satisfied, then tap the save icon to give your image a title, description, and choose to save in-app or onto your device.

For more expressive art ideas, check out these free online soothing art therapy apps for mental peace and stress relief .

Download: MoodArt: Your Emotions in Art for Android | iOS (Free, subscription available)

Try Creative Alternatives to Talk Therapy

If talking to a therapist doesn’t suit your needs, trying a creative alternative could help you look after your mental health. From using prompts for therapeutic journaling to expressive dancing, you'll find plenty of creative therapy options online.

4 Free Creative Alternatives to Talk Therapy That Can Support Your Mental Well-Being

Poetry Is For Everyone: Students Display Their Creative Writing at Rogers Free Library

As part of their Creative Writing Studio class, RWU students from diverse academic disciplines are sharing their poems with the public through the end of May.

Professor Renee Soto stands on the steps in front of the Rogers Free Library with a Creative Writing student on each side of her

BRISTOL, R.I. – A dozen Creative Writing majors and minors are currently displaying their poetry at the Rogers Free Library in downtown Bristol, R.I., in what they are calling a “Wandering Magazine,” an installation that is open to the public.

The project began after Ann Kathrin Weldy, Adult Programming & Outreach Coordinator at the library, asked Renee Soto, Associate Professor of Creative Writing at RWU, if her students wanted to share their work with the library for National Poetry Month in April. Soto said she brought the idea to the students in her Poetry Studio course and a dozen volunteered to participate. The installation was originally scheduled to run until the end of April, but it proved so popular, library staff are keeping it up through the end of May.

“Projects such as this enrich the library and the community in myriad ways. I’m impressed by the creative spirit of the poetry students, and it’s valuable for them to have a platform where their work can be discovered and seen. It’s a real joy to witness patrons and passersby stop to read their words and be inspired,” Weldy said. “We always look forward to collaborating with the amazing students and faculty of Roger Williams University. The university is a treasure in Bristol.”

As part of the installation, each student submitted one poem that they were proud of, which library staff hung on the walls in the foyer entryway and throughout the building for library patrons to read as they browse for books. Soto explained that there were no restrictions on the content or style of the poetry submissions, leaving the choice entirely up to the students. Though some of the students may have been inspired by prompts given in class, it was ultimately their decision which poem they wanted to submit, leading to a diverse array of work.

“The Creative Writing Studio classes are exciting because they are spaces where students emphasize making their own work, and that’s the most important thing for them as artists,” said Soto. “The focus is on developing, reviewing, revising, and – in many ways – recreating work so that it’s ready for an audience. This is perfect because this (installation) at Rogers Free Library is a publication they can put on their résumés.”

Soto noted that she was surprised by how many students in her class weren’t Creative Writing or English Literature majors; some are studying Criminal Justice, Forensic Science, History, and Psychology. “They are just taking it for fun,” she said. “Poetry really is for everyone. It’s incredible.”

Sophomore Lourdes Rodriguez stands in the Rogers Free Library next to her poem "Parasol" which is displayed on the wall

Sophomore Lourdes Rodriguez, a Computer Science major with a minor in Creative Writing from Woonsocket, R.I., shared that the inspiration for her poem, “Parasol,” came from a moment in class when her professor said the word during a lecture. “It was so weird to me because Spanish is my first language. He said it, and I was sitting in class and my mind was just blown. From there, my brain was like, ‘wait, I gotta write, I gotta write.’” Rodriguez said that her poems are typically more emotional, but for this project she wanted to challenge herself to write something out of her comfort zone. That challenge produced a poem that was more whimsical and playful in nature. It is also her first poem – of many, Rodriguez hopes – to include Spanish words and phrases. “I'm just really proud of this piece,” she said.

When Rodriguez started at RWU, she first majored in Journalism but then switched to Computer Science. Not wanting to let go of writing, she said she decided to incorporate her passion into a minor. Now deciding whether to go into coding for mobile apps or software development, she knows that writing will always be part of her life. “It would be great to get published in the future or even just keep writing my poems and short stories for myself,” she said.

sophomore A. Lee stands next to their poem at Rogers Free Library

For sophomore A. Lee, an English Literature and Creative Writing double major from Acton, Mass., the inspiration for their poem came from a prompt that Soto brought to the class, which they tweaked to suit their needs, they said. Their poem, titled “An Assortment of Nonsensical Meeting Places,” was inspired by their time at summer camp growing up but more specifically by the memories they share with their partner. “We have a lot of really fun, really strange memories that I wanted to capture,” said Lee. Snapshots include a moment where Lee got a nosebleed while hiking the Appalachian Mountains, in which the only solution was to shove tampons up their nose, as well as a six-day biking trip. “It's a nostalgia-heavy piece, where I am sort of reflecting on all the fun times we had together,” they said.

For both Lee and Rodriguez, this is the first time either of them has shared their writing in such a public format. The Wandering Magazine helped boost Lee’s confidence as a writer, they said, sharing that they would love to publish a collection of their own work one day.

“It’s nerve-wracking, but it means a lot,” Rodriguez said.

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Celebrating Health Profession Students' Poetry, Prose, and Visual Arts

Program for Humanities in Medicine 2024 Health Professions Creative Writing and Art Contest Awards Ceremony

Lenique Huggins - First place in Art category

Created by MD student Hang Nguyen. Second place in Art category

WInston Trope - Honorable Mention in Art category

Zeynep Inanoglu - Honorable Mention in Art category

2024 PHM Health Professions Creative Writing and Art Contest Award Ceremony - Student Winners

Winning artwork

Black Motherhood in Medicine

Created by MD student Lenique Huggins. First place in Art category

These Small Things

These are the titles of the poetry, prose, and visual artworks that received first-place in the annual Yale School of Medicine (YSM) Program for Humanities in Medicine (PHM) Health Professions Students' Creative Writing & Art Contest. On May 2, the student winners were celebrated at a gathering where they shared and often provided context for their creations. A supportive and appreciative audience applauded enthusiastically after each presentation.

Professor and PHM Director Anna Reisman, MD, welcomed everyone to the celebration, sharing that the contest began more than two decades ago. It originally was a poetry and prose contest just for medical students; the family of Marguerite Rush Lerner, MD, established and endowed the contest to honor her. Lerner was a dermatologist at YSM, as well as a children’s book author. (Lerner’s husband, Aaron Lerner, MD, PhD, was the first chair of Yale’s Department of Dermatology, and two of their four sons, Ethan Lerner, MD, PhD ‘82 and Michael Lerner, MD ’81, attended YSM.) Reisman explained that several years ago the contest expanded to include visual arts, and also students from across the health profession schools and programs—MD, MD-PhD, Physician Associate, Physician Assistant Online, Nursing, and Public Health.

This year, almost 100 students participated in the contest. MD student winners receive the Marguerite Rush-Lerner prize; the other Yale health professions students receive the Program for Humanities in Medicine prize. See the list of winners under "Related Links."

While second-year MD student Lenique Huggins had been thinking about creating Black Motherhood in Medicine for a few months, it only took two evenings to do so, once she began.

She explains that the inspiration for the piece started in her first week of medical school, when she learned that the maternal mortality rate for Black mothers is 2.6 more than non-Hispanic white mothers. “As a young Black woman, this statistic especially pained me and my close friends.” Additionally, she says that in classes throughout the year, she was part of formal and informal discussions about being a mother in medicine. “I heard from classmates across racial backgrounds about their real fears of balancing pregnancy with their medical training and pregnancy complications among medical professionals.” That led her to begin to think about “my intersection as a future Black mother in medicine and the challenges I may face because of these identities. Now, as a second-year student, I created a piece that captures something I have thought much about these past two years.”

Huggins grew up in a Caribbean household close to art and culture from all over the world. “I’ve always been surrounded by music, dance, storytelling, and visual art, and my family hosted international students throughout my childhood. I started playing the piano at age three, and have been singing, dancing, and doodling for as long as I can remember.” However, it was not until she was an undergraduate at Duke University and participated in community service that she “began to understand the therapeutic value of art.”

Through her involvement in different programs at that time, including Families Moving Forward, a shelter for families without homes, and Reflections, a weekly art program for adults with dementia at Duke Nasher Museum, Huggins says, “I saw how encouraging self-expression could bring peace during uncertain times, reduce stress, and empower communities. When I went through a rough time in my sophomore year, I found myself using painting for a lot of healing.”

Huggins continues, “I will continue practicing art. It’s a self-care practice that helps me combat burnout and show up better for patients who need me.”

Class of 2025 MD student Hang Nguyen started painting at age 11, when her family immigrated to America from Vietnam. She explains, “I did not speak English at the time, so art was a vessel through which I could communicate my tumultuous adolescent mind.”

Currently, she paints often and says her favorite subject is “surreal, tranquil, and, occasionally, liminal landscapes, such as a classroom at midnight, an overgrown, abandoned church, and a long corridor that leads nowhere. For me, these landscapes represent a longing for a space that exists tranquilly, where one can be one's true self.”

Nguyen painted Submerged specifically for this contest; “In other words, this contest inspired me to look inward and reflect on — instead of simply overcome and move forward from — the challenges that I have encountered in medical school.” Through the work she wanted “to convey the various feelings that I experienced while studying for board exams using motifs that are near and dear to me like water and fish in a surreal, tranquil, and liminal ambience.” She painted it during time dedicated to Step 1, over the course of a week, working on it for an hour to two at night.

Hunger , On Chinese Medicine , and On the First Day of Anatomy Lab

First-year Physician Associate (PA) student Kelly Dunn was honored with three prizes: A tie for first place in prose for Hunger , a tie for second place in poetry for On Chinese Medicine , and honorable mention in prose for On the First Day of Anatomy Lab , each of which she shared with the audience. While Dunn, who “always considered the humanities to be a part of my life,” has been an avid reader and artist for as long as she can remember, she did not start writing until the COVID-19 pandemic. She says she mostly wrote nonfiction, and only semi-frequently, “whenever something momentous transpired, or I suddenly felt called to it,” explaining, “so much of my love and appreciation for writing comes from the fact that it’s a medium to better articulate an experience through. Having something so fresh and felt so acutely is a wonderful impetus to begin writing.”

The contest was one of Dunn’s first times writing poetry, “I’ve always been intimidated by it. Learning the different poetic forms and metric lines, as well as how to be economical with my words, seems like something I’ll never be able to achieve.” She continued, “I’m grateful for this contest for giving me an opportunity to try”

For Dunn, writing in PA school has been “incredibly helpful processing all that has happened. Every day I vacillate between feelings of immense wonder, humility, and gratitude— and these words in themselves don’t even do the moments I’ve witnessed justice.”

Acknowledgements

Reisman thanked PHM Manager Karen Kolb for her work coordinating the contest, and the 16 YSM faculty and staff members who served as judges:

Aba Black, MD, MHS, Anne Merritt, MD, MS, Terry Dagradi, Sarah Cross, MD, Lorence Gutterman, MD, Melissa Grafe, PhD, Randi Hutter-Epstein, MD, MPH, Kenneth Morford, MD, Sharon Ostfeld-Johns, MD, Vincent Quagliarello, MD, Lisa Sanders, MD, Nora Segar, MD, Elizabeth Marhoffer, MD, Rita Rienzo MMSC, PA-C, Sharon Chekijian, MD, PhH, and Cynthia McNamara, MD.

Featured in this article

Aba Black, MD, MHS
Sharon Anoush Chekijian, MD, MPH
Sarah Cross, MD
Terry Dagradi
Randi Epstein
Melissa Grafe, PhD
Lorence Gutterman, MD
Lenique Huggins
Karen P Kolb
Elizabeth Marhoffer, MD
Cynthia Frary McNamara, MD, FACP
Anne Merritt, MD, MS
Kenneth Morford, MD, FASAM
Hang Nguyen
Sharon Ostfeld-Johns, MD, IBCLC
Vincent Quagliarello, MD
Anna Reisman, MD
Rita Rienzo, MMSc, PA-C
Lisa Sanders, MD, FACP
Nora Segar, MD

Writing Technique Across Psychotherapies—From Traditional Expressive Writing to New Positive Psychology Interventions: A Narrative Review

Open access
Published: 14 September 2021
Volume 52 , pages 23–34, ( 2022 )

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Cristina C. Mortara 1

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The Soul of Therapy: The Therapist’s Use of Self in the Therapeutic Relationship

Regulating Emotionality to Manage Adversity: A Systematic Review of the Relation Between Emotion Regulation and Psychological Resilience

Self-Compassion: What It Is, What It Does, and How It Relates to Mindfulness

Avoid common mistakes on your manuscript.

Introduction

Traditional Applications of Writing Techniques

James Pennebaker: The Paradigm of Expressive Writing

Writing Techniques for Addressing Trauma

McAdams: The Use of Autobiography in the Construction of Self-identity

The Use of the Diary in CBT

Existential Approaches: The Bridge Between Clinical Psychology and Positive Psychology

Logotherapy.

Acceptance and Commitment Therapy

Positive Psychotherapy

Unlike the traditional deficit-oriented approach to psychotherapy, Positive Psychotherapy aims at considering with a similar standing, symptoms and strengths (Rashid & Seligman, 2018 ).

Furthermore, Positive Psychotherapy entails also specific writing techniques devoted to the promotion of specific positive emotions, such as gratitude, forgiveness and wisdom, as described below.

Forgiveness

Forgiveness implies a situation of offense where a person makes the choice of letting go of anger and of searching for a compassionate attitude towards the transgressor (Thoresen et al., 2008 ).

New Applications: Writing on the Web

In this way, unlike traditional handwriting, writing on the web implicates a social function rather than a private one. Sharing, in fact, is a fundamental component of self-writing on the web.

Conclusions

Allen, S. F., Wetherell, M. A., & Smith, M. A. (2020). Online writing about positive life experiences reduces depression and perceived stress reactivity in socially inhibited individuals. Psychiatry Research . https://doi.org/10.1016/j.psychres.2019.112697

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The Authors express their gratitude to Dr. Lorenzo Angiolucci for his contribution in the process of writing and revising this manuscript.

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Ruini, C., Mortara, C.C. Writing Technique Across Psychotherapies—From Traditional Expressive Writing to New Positive Psychology Interventions: A Narrative Review. J Contemp Psychother 52 , 23–34 (2022). https://doi.org/10.1007/s10879-021-09520-9

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Writing Therapy (WT) is defined as a process of investigation about personal thoughts and feelings using the act of writing as an instrument, with the aim of promoting self-healing and personal growth. ... In recent years, expressive and creative writing was found to have beneficial effects on physical and psychological health (Nicholls, 2009).
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Recall the sensations you experienced — what you saw, smelled, heard, felt and tasted. "Absorb the image into your body — feel as if you are reliving the remembered image.". Describe your ...
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Writing therapy involves using the written word, self-expression, and life story for the purposes of healing and self-discovery. There are many ways to engage in healing and personal growth through contemplative practices such as meditation, yoga, mindfulness and in this case, expressive writing. There is well over 35 years of scientific ...
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The Role of Creative Writing in Therapy. Therapists. Jun 14, 2017. Adrian Wilson-Smith. childhood , creativity , therapy , writing. I decided at the start of the year to practice what I preach in my role as a counsellor - to explore creativity as an enhancement to wellbeing - and joined a local creative writing group.
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Creative writing and sharing and discussing creative writing sustained Herbert Hall over the last—and some of the most productive—years of his career. Conclusion This article provided a brief reexamination of the influence of creative arts on OT in the early 20th century, using the correspondence between Herbert J. Hall and Cornelia Lynde ...
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In this article, the authors will describe a creative writing therapeutic group program they developed based on narrative therapy and narrative medicine principles. This was a Social Science and Humanities Research Council—Partnership Engagement Grant funded project, the aim of which was to develop a facilitator's manual for people interested in offering this group, titled "Journey ...
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Creativity therapy is the use of drawing, painting, writing, sculpting, or playing music as a form of stress relief. It is similar to art therapy, but creativity therapy is a more general term for using creativity on your own to help relieve your own stress. Similar to meditation, it teaches your mind to concentrate for long periods of time on ...
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Here are some creative alternatives to talk therapy that can support your mental well-being. 1. Journal Writing Prompt Therapy. Journal writing prompt therapy is exactly as it sounds—you use ...
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These are the titles of the poetry, prose, and visual artworks that received first-place in the annual Yale School of Medicine (YSM) Program for Humanities in Medicine (PHM) Health Professions Students' Creative Writing & Art Contest. On May 2, the student winners were celebrated at a gathering where they shared and often provided context for ...
Writing Technique Across Psychotherapies—From Traditional ...
Writing Therapy (WT) is defined as a process of investigation about personal thoughts and feelings using the act of writing as an instrument, with the aim of promoting self-healing and personal growth. WT has been integrated in specific psychotherapies with the aim of treating specific mental disorders (PTSD, depression, etc.). More recently, WT has been included in several Positive ...

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Writing Technique Across Psychotherapies—From Traditional Expressive Writing to New Positive Psychology Interventions: A Narrative Review

Cristina C. Mortara

Introduction

Traditional Applications of Writing Techniques

James Pennebaker: The Paradigm of Expressive Writing

Writing Techniques for Addressing Trauma

McAdams: The Use of Autobiography in the Construction of Self-identity

The Use of the Diary in CBT

Existential Approaches: The Bridge Between Clinical Psychology and Positive Psychology

Acceptance and Commitment Therapy

Positive Psychotherapy

Forgiveness

New Applications: Writing on the Web

Conclusions

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Posttraumatic Stress Disorder

Bereavement

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